Łagodny przerost gruczołu krokowego
Rokowania, prognozy i postęp choroby
Łagodny przerost gruczołu krokowego (BPH) jest powszechnym schorzeniem u mężczyzn, z częstością występowania sięgającą 50% w wieku 60 lat i 90% w wieku 85 lat. Progresja choroby objawia się nasileniem objawów dolnych dróg moczowych (LUTS), a w ciągu 48 miesięcy 31% pacjentów wymaga dalszego leczenia, a 5% doświadcza ostrego zatrzymania moczu (AUR). Czynniki ryzyka progresji obejmują wiek, objętość prostaty powyżej 30 g, obwód talii, BMI oraz siedzący tryb życia. Nomogramy prognostyczne, takie jak P.R.OS.T.A.T.E, umożliwiają ocenę ryzyka interwencji farmakologicznych lub chirurgicznych oraz przewidywanie skuteczności TURP, z czułością i swoistością sięgającą odpowiednio 79,2% i 85,1%. Terapie obejmują inhibitory 5-alfa-reduktazy, które zmniejszają ryzyko AUR i potrzeby operacji, alfa-blokery oraz zabiegi chirurgiczne, z TURP jako złotym standardem, osiągającym sukces terapeutyczny u 81% pacjentów.
Łagodny przerost gruczołu krokowego (BPH) – Prognozy
Łagodny przerost gruczołu krokowego (BPH) jest najczęstszym problemem prostaty wśród mężczyzn. Niemal wszyscy mężczyźni doświadczą pewnego stopnia powiększenia prostaty wraz z wiekiem. Około 50% mężczyzn w wieku 60 lat wykazuje objawy BPH, a odsetek ten wzrasta do 90% w wieku 85 lat. Około połowa wszystkich pacjentów z BPH rozwinie objawy wymagające leczenia.1 Przewidywanie przebiegu choroby i wyników leczenia stanowi istotny aspekt opieki nad pacjentem z łagodnym przerostem gruczołu krokowego.
Naturalna progresja choroby
Pogorszenie objawów ze strony dolnych dróg moczowych (LUTS) z narastającymi problemami z oddawaniem moczu jest najczęstszym wskaźnikiem progresji BPH. Badania obserwacyjne wykazały, że w przypadku braku leczenia, kliniczna progresja BPH zwiększa się w okresie 48 miesięcy, przy czym 31% kohorty wymaga dalszego leczenia, a u 5% rozwija się ostre zatrzymanie moczu w tym samym okresie. Ryzyko ostrego zatrzymania moczu wzrasta z wiekiem.2
Bez odpowiedniego leczenia BPH niesie ze sobą znaczące ryzyko progresji. Mężczyźni ze znacznie powiększoną prostatą (powyżej 30 g) są bardziej narażeni na progresję choroby. W jednym z badań wykazano, że do 42% mężczyzn, którzy zgłosili się z zatrzymaniem moczu, ostatecznie musiało poddać się zabiegowi chirurgicznemu.3
W przeszłości przewlekła końcowa obstrukcja dróg moczowych (BOO) często prowadziła do niewydolności nerek i mocznicy. Chociaż to powikłanie stało się znacznie rzadsze, przewlekła BOO wtórna do BPH może prowadzić do zatrzymania moczu, przewlekłej choroby nerek, nawracających infekcji dróg moczowych, masywnego krwiomoczu i kamicy pęcherza.4
Czynniki prognostyczne wpływające na przebieg choroby
Objętość prostaty może zwiększać się z czasem u mężczyzn z BPH. Ponadto szczytowy przepływ moczu, objętość oddawanego moczu i objawy mogą się pogarszać z czasem u mężczyzn z nieleczonym BPH. Ryzyko ostrego zatrzymania moczu (AUR) i potrzeba leczenia operacyjnego zwiększają się z wiekiem.5
Badania wykazały, że istnieje kilka kluczowych czynników związanych z ryzykiem progresji BPH. Wiek, wynik skali objawów, szczytowy przepływ moczu (Qmax), poziom antygenu specyficznego dla prostaty (PSA) oraz objętość moczu zalegającego po mikcji są istotnie związane z wynikami leczenia.6
Badania nad czynnikami przyczynowymi wykazały niezależne związki przyczynowe między pewnymi czynnikami stylu życia a rozwojem BPH:
- Zwiększony obwód talii i otyłość centralna są istotnym czynnikiem ryzyka BPH
- Wyższy wskaźnik masy ciała (BMI) wykazuje sugestywny związek przyczynowy z BPH
- Siedzący tryb życia jest niezależnie i przyczynowo związany ze zwiększonym ryzykiem BPH
- Brak jest przekonujących dowodów na związek przyczynowy między względnym spożyciem węglowodanów, tłuszczów, białek i cukrów, paleniem tytoniu oraz piciem alkoholu a ryzykiem BPH78
Narzędzia prognostyczne w BPH
Opracowano nowatorskie narzędzia prognostyczne do przewidywania ryzyka progresji BPH oraz skuteczności interwencji terapeutycznych:
Nomogram do przewidywania ryzyka interwencji farmaceutycznych lub chirurgicznych związanych z objawami BPH został opracowany na podstawie badań pacjentów z łagodnym przerostem prostaty. Według tego modelu można zaproponować progi >75% i >40% dla wysokiego ryzyka oraz <25% i <5% dla niskiego ryzyka interwencji farmaceutycznych lub chirurgicznych w ciągu 10 lat od pierwszej prezentacji objawów.9
Nomogram P.R.OS.T.A.T.E jest kolejnym narzędziem, które obiektywnie i dokładnie przewiduje skuteczność przezcewkowej resekcji prostaty (TURP). Nomogram ten wykazał dobrą dokładność w szacowaniu prawdopodobieństwa skuteczności TURP, z wskaźnikiem C wynoszącym 0,860 (95% przedział ufności 0,808-0,911). Przy punkcie odcięcia 177 punktów, nomogram miał czułość i swoistość odpowiednio 79,2% i 85,1% w kohorcie podstawowej oraz 70,6% i 75,6% w kohorcie walidacyjnej.10
Skuteczność leczenia i długoterminowe rokowanie
Całkowite rokowanie dla osób z BPH jest bardzo dobre. Chociaż BPH nie ma leczenia przyczynowego, dostępne terapie mogą złagodzić objawy. Łagodne objawy mogą nie wymagać leczenia, natomiast leki, zabiegi chirurgiczne i leczenie małoinwazyjne mogą skutecznie leczyć cięższe przypadki.11
Inhibitory 5-alfa-reduktazy wykazały zmniejszenie częstości występowania zatrzymania moczu i opóźnienie potrzeby operacji, podczas gdy alfa-blokery nie wykazały takiego efektu.12
Przezcewkowa resekcja prostaty (TURP) jest uważana za złoty standard w usuwaniu przeszkody podpęcherzowej (BOO) wtórnej do BPH. W badaniach obserwowano ścisły sukces terapeutyczny u 81% pacjentów poddanych zabiegowi chirurgicznemu prostaty w okresie obserwacji od 3 miesięcy do 3 lat.13
Zidentyfikowano również czynniki korzystne i niekorzystne wpływające na wynik zabiegu:
- Korzystne czynniki: objawowy duży gruczolak prostaty potwierdzony w badaniach IVU, TRSP lub UPP
- Niekorzystne czynniki: mały gruczolak, niepewne objawy podrażnieniowe i niedoczynność wypieracza
Pacjenci z więcej niż 2 niekorzystnymi czynnikami powinni być dokładnie zbadani przed operacją. Obecność 2 korzystnych czynników bez czynników niekorzystnych zwykle pozwala przewidzieć najlepszy wynik operacji.14
Przyszłe trendy i prognoza globalna
Trwające obciążenie BPH stanowi krytyczne wyzwanie dla zdrowia publicznego. Rosnąca częstość występowania wśród populacji w średnim i starszym wieku podkreśla konieczność walki z tym powszechnym schorzeniem.15
Zgodnie z prognozami, globalna zachorowalność i częstość występowania mają wzrosnąć z 962,42 do 7878,68 na 100 000 populacji w 2022 r. do 998,55 i 8620,60 na 100 000 populacji w 2035 r. Badania wykazały, że najwyższa zachorowalność na BPH występuje w przedziale wiekowym 60-79 lat, podczas gdy wiek powyżej 80 lat to etap z najwyższą częstością występowania BPH w 2035 roku.16
W związku z tym ukierunkowane programy badań przesiewowych i wczesnej diagnostyki mogłyby być wdrażane u mężczyzn w wieku 50-60 lat, gdy zachorowalność na BPH gwałtownie rośnie, aby zidentyfikować i leczyć schorzenie, zanim osiągnie bardziej zaawansowane stadia.17
Uznanie specyficznych dla wieku wzorców w epidemiologii BPH podkreśla potrzebę odpowiednich dla wieku strategii zapobiegania, badań przesiewowych i leczenia w celu poprawy wyników zdrowotnych i jakości życia mężczyzn dotkniętych tym powszechnym schorzeniem. Formułowanie strategii, które kładą nacisk na profilaktykę, ułatwiają terminowe rozpoznanie i zapewniają skuteczne leczenie, może przyczynić się do złagodzenia zarówno bezpośrednich, jak i pośrednich skutków BPH, ostatecznie zmniejszając ogólne obciążenie chorobą.18
Porównanie skuteczności różnych metod leczenia BPH
Pacjenci, którzy nie są zaniepokojeni swoimi objawami i nie doświadczają powikłań związanych z BPH, powinni być leczeni strategią uważnej obserwacji (watchful waiting). Pacjenci z łagodnymi objawami ze strony dolnych dróg moczowych (LUTS) mogą być początkowo leczeni farmakologicznie.19
W badaniach porównawczych obserwowano, że spośród pacjentów leczonych fitoterapią, 47% przerwało lub kontynuowało tę formę terapii, podczas gdy 53% przeszło na alfa-blokery i/lub inhibitory 5-alfa-reduktazy po medianie czasu wynoszącej 24 miesiące. Jedna trzecia pacjentów w drugiej grupie doświadczyła progresji klinicznej po medianie czasu wynoszącej 54 miesiące.20
TURP jest najbardziej skuteczną metodą leczenia większości przypadków BPH. Jednak u pacjentów w wieku 65 lat i starszych preferowane są leki i małoinwazyjne metody leczenia. Starsi pacjenci mogą mieć więcej powikłań i dłuższy czas rekonwalescencji po operacji.21
Małoinwazyjne terapie, które mają na celu osiągnięcie efektów TURP przy jednoczesnym uniknięciu jego działań niepożądanych, zyskują coraz większą popularność. Te metody stanowią obiecującą alternatywę dla tradycyjnych zabiegów chirurgicznych, szczególnie w populacjach o zwiększonym ryzyku powikłań operacyjnych.22
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Materiały źródłowe
- #1 Benign Prostatic Hyperplasia (BPH): Symptoms & Treatmenthttps://my.clevelandclinic.org/health/diseases/9100-benign-prostatic-hyperplasia
The outlook for people with BPH is very good. BPH doesn’t have a cure, but treatments can help alleviate your symptoms. Mild symptoms may not require treatment. Medications, surgery and minimally invasive treatments can treat more severe cases. […] BPH is the most common prostate problem among males. Almost all people with a prostate will develop some enlargement in their prostates as they grow older. […] By age 60, about 50% of people with a prostate will have some signs of BPH. By age 85, about 90% will have signs of the condition. […] About half of all people with BPH will develop symptoms that require treatment. […] There isn’t a cure for BPH. However, treatment options are available to help alleviate your symptoms. […] TURP is the most effective treatment for most cases of BPH. However, in adults 65 and older, medications and minimally invasive treatments are preferable. Older patients may have more complications and a longer recovery time after surgery.
- #2 Benign Prostatic Hyperplasia – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK558920/
Deterioration in LUTS with increasingly problematic voiding symptoms is the most common indicator of BPH disease progression. […] Observational studies have demonstrated that when left without treatment, clinical progression of BPH increased over 48 months, with 31% of the cohort requiring further treatment and 5% developing acute retention in the same period. […] The risk of acute urinary retention increases with age. […] Left untreated, BPH has a significant risk of progression. […] Men with significantly enlarged prostates (30 gm) are at increased risk of disease progression. […] In another study, up to 42% of men who presented with urinary retention went on to have surgery. […] The 5 alpha-reductase inhibitors have been shown to reduce the incidence of urinary retention and delay the need for surgery, while alpha-blockers have not.
- #3 Benign Prostatic Hyperplasia – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK558920/
Deterioration in LUTS with increasingly problematic voiding symptoms is the most common indicator of BPH disease progression. […] Observational studies have demonstrated that when left without treatment, clinical progression of BPH increased over 48 months, with 31% of the cohort requiring further treatment and 5% developing acute retention in the same period. […] The risk of acute urinary retention increases with age. […] Left untreated, BPH has a significant risk of progression. […] Men with significantly enlarged prostates (30 gm) are at increased risk of disease progression. […] In another study, up to 42% of men who presented with urinary retention went on to have surgery. […] The 5 alpha-reductase inhibitors have been shown to reduce the incidence of urinary retention and delay the need for surgery, while alpha-blockers have not.
- #4 Benign Prostatic Hyperplasia (BPH): Practice Essentials, Background, Anatomyhttps://emedicine.medscape.com/article/437359-overview
In the past, chronic end-stage BOO often led to kidney failure and uremia. Although this complication has become much less common, chronic BOO secondary to BPH may lead to urinary retention, chronic kidney disease, recurrent urinary tract infections, gross hematuria, and bladder calculi. […] Prostate volume may increase over time in men with BPH. In addition, peak urinary flow, voided volume, and symptoms may worsen over time in men with untreated BPH. The risk of AUR and the need for corrective surgery increases with age. […] Patients who are not bothered by their symptoms and are not experiencing complications of BPH should be managed with a strategy of watchful waiting. Patients with mild LUTS can be treated initially with medical therapy. Transurethral resection of the prostate (TURP) is considered the criterion standard for relieving bladder outlet obstruction (BOO) secondary to BPH. However, minimally invasive therapies to accomplish the goal of TURP while avoiding its adverse effects are gaining wide use.
- #5 Benign Prostatic Hyperplasia (BPH): Practice Essentials, Background, Anatomyhttps://emedicine.medscape.com/article/437359-overview
In the past, chronic end-stage BOO often led to kidney failure and uremia. Although this complication has become much less common, chronic BOO secondary to BPH may lead to urinary retention, chronic kidney disease, recurrent urinary tract infections, gross hematuria, and bladder calculi. […] Prostate volume may increase over time in men with BPH. In addition, peak urinary flow, voided volume, and symptoms may worsen over time in men with untreated BPH. The risk of AUR and the need for corrective surgery increases with age. […] Patients who are not bothered by their symptoms and are not experiencing complications of BPH should be managed with a strategy of watchful waiting. Patients with mild LUTS can be treated initially with medical therapy. Transurethral resection of the prostate (TURP) is considered the criterion standard for relieving bladder outlet obstruction (BOO) secondary to BPH. However, minimally invasive therapies to accomplish the goal of TURP while avoiding its adverse effects are gaining wide use.
- #6 A Novel Nomogram Based on Initial Features to Predict BPH Progressionhttps://www.mdpi.com/1660-4601/19/15/9738
A total of 107 patients with a median age of 55 years at presentation were included; 47% stopped or continued phytotherapy, while 53% switched to alpha-blockers and/or 5-ARI after a median time of 24 months. […] One-third in the second group experienced clinical progression after a median time of 54 months. […] Age, symptom score, peak flow rate (Qmax), prostate-specific antigen (PSA), and post-void residual volume were significantly associated with the outcomes. […] We developed a nomogram to predict the risk of pharmaceutical or surgical interventions for BPH-related LUTS at 10 years from presentation. […] On the basis of our models, thresholds of >75% and >40% for high risk and <25% and <5% for low risk of pharmaceutical or surgical interventions, respectively, can be proposed.
- #7 Causal relationship between obesity, lifestyle factors and risk of benign prostatic hyperplasia: a univariable and multivariable Mendelian randomization study | Journal of Translational Medicine | Full Texthttps://translational-medicine.biomedcentral.com/articles/10.1186/s12967-022-03722-y
Obesity (waist circumference, body mass index (BMI)) and lifestyle factors (dietary habits, smoking, alcohol drinking, Sedentary behavior) have been associated with risk of benign prostatic hyperplasia (BPH) in observational studies, but whether these associations are causal is unclear. […] This study supports independent causal roles of high waist circumference, BMI and sedentary behavior in BPH. […] Our MR study supports that genetic predisposition to higher waist circumference and sedentary behavior are independently and causally associated with the risk of BPH. […] Suggestive causal association is observed between genetic predisposition to higher BMI and increased risk of BPH. […] There is no obvious evidence that genetic predisposition to relative carbohydrate, fat, protein, and sugar intake, smoking and alcohol drinking are causally associated with the risk of BPH.
- #8 Causal relationship between obesity, lifestyle factors and risk of benign prostatic hyperplasia: a univariable and multivariable Mendelian randomization study | Journal of Translational Medicine | Full Texthttps://translational-medicine.biomedcentral.com/articles/10.1186/s12967-022-03722-y
The association between waist circumference and BPH remained after the adjustment for BMI, which suggested that central obesity is a vital risk factor as overall fat mass for BMI. […] Our MR study strengthened the causal nature of the positive association between sedentary behavior and BPH and further revealed that this association was independent of BMI. […] In conclusion, our study provides MR evidence supporting a significantly causal role of waist circumference and sedentary behavior in BPH. The suggestive association between genetic predisposition to higher BMI and BPH risk needs verification.
- #9 A Novel Nomogram Based on Initial Features to Predict BPH Progressionhttps://www.mdpi.com/1660-4601/19/15/9738
A total of 107 patients with a median age of 55 years at presentation were included; 47% stopped or continued phytotherapy, while 53% switched to alpha-blockers and/or 5-ARI after a median time of 24 months. […] One-third in the second group experienced clinical progression after a median time of 54 months. […] Age, symptom score, peak flow rate (Qmax), prostate-specific antigen (PSA), and post-void residual volume were significantly associated with the outcomes. […] We developed a nomogram to predict the risk of pharmaceutical or surgical interventions for BPH-related LUTS at 10 years from presentation. […] On the basis of our models, thresholds of >75% and >40% for high risk and <25% and <5% for low risk of pharmaceutical or surgical interventions, respectively, can be proposed.
- #10 Nomogram for Efficacy Prediction of Transurethral Resection | CIAhttps://www.dovepress.com/the-prostate-nomogram-for-the-preoperative-prediction-of-clinical-effi-peer-reviewed-fulltext-article-CIA
The P.R.OS.T.A.T.E nomogram objectively and accurately predicted TURP efficacy, thereby facilitating the clinical decision-making process. […] The optimal cutoff total nomogram score was 177, with a maximum Youden index of 0.643. […] The C-index for predicting TURP efficacy was 0.860 (95% confidence interval [CI], 0.808 0.911). […] The nomogram demonstrated good accuracy in estimating the likelihood of TURP efficacy, with a C-index (which was equivalent to the area under the curve (AUC)) of 0.860 (95% CI, 0.8080.911). […] The probability of effective TURP can be determined by assigning points for each variable by drawing a line upward from the corresponding variable to the points line, summing the points, and identifying the prediction associated with the total points line. […] The nomogram achieved good predictive accuracy; at a cutoff point of 177, the nomogram had a sensitivity and specificity of 79.2% and 85.1% in the primary cohort and 70.6% and 75.6% in the validation cohort, respectively.
- #11 Benign Prostatic Hyperplasia (BPH): Symptoms & Treatmenthttps://my.clevelandclinic.org/health/diseases/9100-benign-prostatic-hyperplasia
The outlook for people with BPH is very good. BPH doesn’t have a cure, but treatments can help alleviate your symptoms. Mild symptoms may not require treatment. Medications, surgery and minimally invasive treatments can treat more severe cases. […] BPH is the most common prostate problem among males. Almost all people with a prostate will develop some enlargement in their prostates as they grow older. […] By age 60, about 50% of people with a prostate will have some signs of BPH. By age 85, about 90% will have signs of the condition. […] About half of all people with BPH will develop symptoms that require treatment. […] There isn’t a cure for BPH. However, treatment options are available to help alleviate your symptoms. […] TURP is the most effective treatment for most cases of BPH. However, in adults 65 and older, medications and minimally invasive treatments are preferable. Older patients may have more complications and a longer recovery time after surgery.
- #12 Benign Prostatic Hyperplasia – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK558920/
Deterioration in LUTS with increasingly problematic voiding symptoms is the most common indicator of BPH disease progression. […] Observational studies have demonstrated that when left without treatment, clinical progression of BPH increased over 48 months, with 31% of the cohort requiring further treatment and 5% developing acute retention in the same period. […] The risk of acute urinary retention increases with age. […] Left untreated, BPH has a significant risk of progression. […] Men with significantly enlarged prostates (30 gm) are at increased risk of disease progression. […] In another study, up to 42% of men who presented with urinary retention went on to have surgery. […] The 5 alpha-reductase inhibitors have been shown to reduce the incidence of urinary retention and delay the need for surgery, while alpha-blockers have not.
- #13 Predictive factors for successful surgical outcome of benign prostatic hypertrophy – PubMedhttps://pubmed.ncbi.nlm.nih.gov/7689968/
Four hundred patients with benign prostatic hypertrophy (BPH) undergoing prostatic surgery were enrolled in this study in order to search for factors predictive of a successful outcome. […] In the follow-up period of 3 months to 3 years, a strictly successful result was achieved in 324 patients (81%). […] On analysis of the success rate, 9 favorable factors and 9 unfavorable factors were noted. […] A symptomatic large prostatic adenoma proven by IVU, TRSP, or UPP will imply a higher success rate. […] Urodynamically obstructive BPH proven by a high voiding pressure and constrictive flow pattern can also predict a satisfactory outcome. […] The unfavorable factors always come from a small adenoma, uncertain irritative symptoms and detrusor underactivity. […] Patients with more than 2 unfavorable factors should be investigated carefully before surgery. […] The presence of 2 favorable factors without an unfavorable factor will usually predict the best surgical outcome.
- #14 Predictive factors for successful surgical outcome of benign prostatic hypertrophy – PubMedhttps://pubmed.ncbi.nlm.nih.gov/7689968/
Four hundred patients with benign prostatic hypertrophy (BPH) undergoing prostatic surgery were enrolled in this study in order to search for factors predictive of a successful outcome. […] In the follow-up period of 3 months to 3 years, a strictly successful result was achieved in 324 patients (81%). […] On analysis of the success rate, 9 favorable factors and 9 unfavorable factors were noted. […] A symptomatic large prostatic adenoma proven by IVU, TRSP, or UPP will imply a higher success rate. […] Urodynamically obstructive BPH proven by a high voiding pressure and constrictive flow pattern can also predict a satisfactory outcome. […] The unfavorable factors always come from a small adenoma, uncertain irritative symptoms and detrusor underactivity. […] Patients with more than 2 unfavorable factors should be investigated carefully before surgery. […] The presence of 2 favorable factors without an unfavorable factor will usually predict the best surgical outcome.
- #15 Global, regional, and national burden of benign prostatic hyperplasia from 1990 to 2021 and projection to 2035 | BMC Urology | Full Texthttps://bmcurol.biomedcentral.com/articles/10.1186/s12894-025-01715-9
Benign prostatic hyperplasia (BPH) is a common male urological disease around the world. This study aimed to evaluate global, regional, and national burden of BPH from 1990 to 2021, and to forecast the incidence and prevalence of BPH to 2035. […] The persistent burden of BPH continues to pose a critical public health challenge. The escalating prevalence among middle-aged and elderly populations underscores the imperative to tackle this widespread condition. […] The global incidence and prevalence are expected to increase from 962.42 to 7878.68 per 100,000 populations in 2022 to 998.55 and 8620.60 per 100,000 populations in 2035, respectively. […] Our study found that the highest incidence of BPH occurs at the age range of 60-79, while the age over 80 is the stage with the highest prevalence of BPH in 2035.
- #16 Global, regional, and national burden of benign prostatic hyperplasia from 1990 to 2021 and projection to 2035 | BMC Urology | Full Texthttps://bmcurol.biomedcentral.com/articles/10.1186/s12894-025-01715-9
Benign prostatic hyperplasia (BPH) is a common male urological disease around the world. This study aimed to evaluate global, regional, and national burden of BPH from 1990 to 2021, and to forecast the incidence and prevalence of BPH to 2035. […] The persistent burden of BPH continues to pose a critical public health challenge. The escalating prevalence among middle-aged and elderly populations underscores the imperative to tackle this widespread condition. […] The global incidence and prevalence are expected to increase from 962.42 to 7878.68 per 100,000 populations in 2022 to 998.55 and 8620.60 per 100,000 populations in 2035, respectively. […] Our study found that the highest incidence of BPH occurs at the age range of 60-79, while the age over 80 is the stage with the highest prevalence of BPH in 2035.
- #17 Global, regional, and national burden of benign prostatic hyperplasia from 1990 to 2021 and projection to 2035 | BMC Urology | Full Texthttps://bmcurol.biomedcentral.com/articles/10.1186/s12894-025-01715-9
Therefore, targeted screening and early diagnosis programs could be implemented for men in their 50s and 60s, when the incidence of BPH is rapidly rising, to identify and manage the condition before it progresses to more severe stages. […] Overall, the recognition of the age-specific patterns in BPH epidemiology highlights the need for age-appropriate prevention, screening, and management strategies to improve the health outcomes and quality of life of men affected by this common condition. […] In conclusion, the persistent burden of BPH continues to pose a critical public health challenge. The escalating prevalence among middle-aged and elderly populations underscores the imperative to tackle this widespread condition. Formulating strategies that emphasize prevention, facilitate timely diagnosis, and ensure effective management can contribute to mitigating both the direct and indirect impacts of BPH, ultimately reducing the overall burden of the disease.
- #18 Global, regional, and national burden of benign prostatic hyperplasia from 1990 to 2021 and projection to 2035 | BMC Urology | Full Texthttps://bmcurol.biomedcentral.com/articles/10.1186/s12894-025-01715-9
Therefore, targeted screening and early diagnosis programs could be implemented for men in their 50s and 60s, when the incidence of BPH is rapidly rising, to identify and manage the condition before it progresses to more severe stages. […] Overall, the recognition of the age-specific patterns in BPH epidemiology highlights the need for age-appropriate prevention, screening, and management strategies to improve the health outcomes and quality of life of men affected by this common condition. […] In conclusion, the persistent burden of BPH continues to pose a critical public health challenge. The escalating prevalence among middle-aged and elderly populations underscores the imperative to tackle this widespread condition. Formulating strategies that emphasize prevention, facilitate timely diagnosis, and ensure effective management can contribute to mitigating both the direct and indirect impacts of BPH, ultimately reducing the overall burden of the disease.
- #19 Benign Prostatic Hyperplasia (BPH): Practice Essentials, Background, Anatomyhttps://emedicine.medscape.com/article/437359-overview
In the past, chronic end-stage BOO often led to kidney failure and uremia. Although this complication has become much less common, chronic BOO secondary to BPH may lead to urinary retention, chronic kidney disease, recurrent urinary tract infections, gross hematuria, and bladder calculi. […] Prostate volume may increase over time in men with BPH. In addition, peak urinary flow, voided volume, and symptoms may worsen over time in men with untreated BPH. The risk of AUR and the need for corrective surgery increases with age. […] Patients who are not bothered by their symptoms and are not experiencing complications of BPH should be managed with a strategy of watchful waiting. Patients with mild LUTS can be treated initially with medical therapy. Transurethral resection of the prostate (TURP) is considered the criterion standard for relieving bladder outlet obstruction (BOO) secondary to BPH. However, minimally invasive therapies to accomplish the goal of TURP while avoiding its adverse effects are gaining wide use.
- #20 A Novel Nomogram Based on Initial Features to Predict BPH Progressionhttps://www.mdpi.com/1660-4601/19/15/9738
A total of 107 patients with a median age of 55 years at presentation were included; 47% stopped or continued phytotherapy, while 53% switched to alpha-blockers and/or 5-ARI after a median time of 24 months. […] One-third in the second group experienced clinical progression after a median time of 54 months. […] Age, symptom score, peak flow rate (Qmax), prostate-specific antigen (PSA), and post-void residual volume were significantly associated with the outcomes. […] We developed a nomogram to predict the risk of pharmaceutical or surgical interventions for BPH-related LUTS at 10 years from presentation. […] On the basis of our models, thresholds of >75% and >40% for high risk and <25% and <5% for low risk of pharmaceutical or surgical interventions, respectively, can be proposed.
- #21 Benign Prostatic Hyperplasia (BPH): Symptoms & Treatmenthttps://my.clevelandclinic.org/health/diseases/9100-benign-prostatic-hyperplasia
The outlook for people with BPH is very good. BPH doesn’t have a cure, but treatments can help alleviate your symptoms. Mild symptoms may not require treatment. Medications, surgery and minimally invasive treatments can treat more severe cases. […] BPH is the most common prostate problem among males. Almost all people with a prostate will develop some enlargement in their prostates as they grow older. […] By age 60, about 50% of people with a prostate will have some signs of BPH. By age 85, about 90% will have signs of the condition. […] About half of all people with BPH will develop symptoms that require treatment. […] There isn’t a cure for BPH. However, treatment options are available to help alleviate your symptoms. […] TURP is the most effective treatment for most cases of BPH. However, in adults 65 and older, medications and minimally invasive treatments are preferable. Older patients may have more complications and a longer recovery time after surgery.
- #22 Benign Prostatic Hyperplasia (BPH): Practice Essentials, Background, Anatomyhttps://emedicine.medscape.com/article/437359-overview
In the past, chronic end-stage BOO often led to kidney failure and uremia. Although this complication has become much less common, chronic BOO secondary to BPH may lead to urinary retention, chronic kidney disease, recurrent urinary tract infections, gross hematuria, and bladder calculi. […] Prostate volume may increase over time in men with BPH. In addition, peak urinary flow, voided volume, and symptoms may worsen over time in men with untreated BPH. The risk of AUR and the need for corrective surgery increases with age. […] Patients who are not bothered by their symptoms and are not experiencing complications of BPH should be managed with a strategy of watchful waiting. Patients with mild LUTS can be treated initially with medical therapy. Transurethral resection of the prostate (TURP) is considered the criterion standard for relieving bladder outlet obstruction (BOO) secondary to BPH. However, minimally invasive therapies to accomplish the goal of TURP while avoiding its adverse effects are gaining wide use.