Natural history of benign prostatic hypertrophy and acute urinary retention

Acute Urinary Retention: a review of the aetiology and management

“…1,2 The reported incidence varies between studies from a 4 to 73% 10-year risk of AUR. 3,4 One of the most common causes of acute urinary retention is benign prostatic hyperplasia (BPH), which with an ageing population is likely to increase. It may be anticipated, therefore, that the incidence of AUR will also rise, unless preventative measures are taken for the treatment of BPH.…”

Patient Reports of Symptoms and Quality of Life following Prostate Surgery

“…The goal of surgery is usually to reduce everyday symptoms associated with urination or to reduce the risk of episodes of acute retention [1,2], The research reported here, initiated by urologists associated with the Maine Medical Assessment Program, was undertaken to document the benefits of surgery from the patient's point of view and to develop better profiles of patients whose symptoms are most or least likely to bene fit from surgical intervention [3]. This paper reviews the results of the study, focusing on patient-reported symp toms and selected quality-of-life issues that may be re lated to BPH symptoms, both before and after prostatec tomy.…”

The Natural History of Benign Prostatic Hyperplasia: Implications for Patient Care and Clinical Trial Design

“…Normal values for men have been deter mined as a function of age and voided volume [15][16][17][18][19][20], Maximum flow rates below 10 ml/s in men with symp toms of BPH are associated with obstruction [9,21], In a study of 64 men with clinically diagnosed BPH followed over 5 years, Ball and coworkers [22] found a decrease of 1.2 ml/s. This is in agreement with the value of 2.1 ml/s per decade found in a survey of normal men [17], While some statistically significant relationships between symp toms and maximum urinary flow rates have been ob tained, the correlations are weak and sensitivity and spec ificity are poor [10,23,24], Urinary flow rate alone can not be used to diagnose bladder outflow obstruction or to predict favorable response to prostatectomy [9,25,26], Most information on the clinical course of BPH has been obtained from relatively small series of patients fol lowed in urology clinics for symptoms of prostatism over various time periods [10,22,27], These studies have shown that the clinical course of BPH in individual patients is highly variable over time, whether measured by symptoms or by urinary flow rates. An appreciable fraction of patients improve spontaneously without treat ment.…”