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Prevalence and incidence rates for benign prostatic hyperplasia and lower urinary tract symptoms (BPH/LUTS) have not previously been summarized in the literature by age group, symptom severity, and/or race/ethnicity.
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BPH/LUTS prevalence rates ranged from 50% to 75% among men 50 years of age and older to 80% among men 70 years of age and older. Overall incidence rates ranged from 8.5 to 41 cases/1000 person–years.
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BPH/LUTS epidemiologic estimates generally increased with increasing age. Unmeasured
The Epidemiology of Benign Prostatic Hyperplasia Associated with Lower Urinary Tract Symptoms: Prevalence and Incident Rates
Section snippets
Key points
Benign Prostatic Hyperplasia
Clinical BPH is a histologic diagnosis of a progressive enlargement of the prostate gland resulting from nonmalignant proliferation of smooth muscle and epithelial prostate cells.5 BPH disease progression can lead to growth in the transition zone of the prostate gland, called benign prostatic enlargement (BPE), which results from proliferation of fibroblasts and epithelial glandular elements near the urethra.6, 7 Men with clinical BPH typically have prostate volumes of at least 20 mL.8
Lower Urinary Tract Symptoms
Fifty
Risk factors and comorbidities
Medical and lifestyle predictors of BPH/LUTS have been primarily studied despite the high disease burden that should prompt researchers to assess population-level BPH/LUTS sociodemographic and environmental risk factors.
Known risk factors associated with BPH/LUTS12, 13, 14, 15, 16 include
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Age
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Sedentary lifestyle
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Lack of exercise
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Smoking
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Excessive alcohol consumption
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Hypertension
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Type II diabetes
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Depression
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Cardiovascular disease
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Hyperlipidemia
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Central obesity/waist circumference
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Hypogonadism
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Prostate
Prevalence/incidence
Disentangling BPH, LUTS, and BPH/LUTS prevalence and incidence rates reported in the literature is difficult due to the varying disease definitions and assessment methods used between studies.20 Because of these differences in disease definitions and reporting methods such as self-report qualitative and/or quantitative symptoms or diagnoses versus medical record reviews performed by trained medical professionals, BPH, LUTS, and BPH/LUTS estimates in the literature should be interpreted with
Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms Estimates: Comparison
The relationship between BPH, LUTS, bladder outlet obstruction, and benign prostatic enlargement is complex. This complexity can lead to problems with epidemiologic definitions between studies.
There are several factors that complicate BPH/LUTS prevalence and incidence rate comparisons. First, there is an insufficient consensus on the epidemiologic definition of BPH, LUTS, and BPH/LUTS. Different studies often calculate prevalence and incidence using different disease definitions and assessment
Clinical correlation
Worldwide, populations are aging. This correlates to an increase in the number of older men and an increase in life expectancy. As BPH/LUTS is an age-related disease that increases in prevalence and incidence as men get older, appropriate management and use of resources for BPH/LUTS, and other age-related conditions, is a major challenge for the health care system. Recently, there has been a shift from surgical procedures to medical therapy for BPH/LUTS treatment. This is thought to be a result
Summary
The number of men diagnosed with BPH/LUTS in the last decade has been increasing over time. Prostate enlargement, specifically BPH, has been shown to be associated with the symptomatic progression of LUTS. Numerous cross-sectional and longitudinal studies have provided data on BPH, LUTS, and BPH/LUTS prevalence and incidence rates and their increase over time and age-related associations. Each prevalence may be increasing due to an increase in BPH/LUTS disease awareness and diagnosis, the
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