Korean J Urol.  2012 Mar;53(3):139-148.

Benign Prostatic Hyperplasia: from Bench to Clinic

• Yoo TK
• Cho HJ

Abstract

Benign prostatic hyperplasia (BPH) is a prevalent disease, especially in old men, and often results in lower urinary tract symptoms (LUTS). This chronic disease has important care implications and financial risks to the health care system. LUTS are caused not only by mechanical prostatic obstruction but also by the dynamic component of obstruction. The exact etiology of BPH and its consequences, benign prostatic enlargement and benign prostatic obstruction, are not identified. Various theories concerning the causes of benign prostate enlargement and LUTS, such as metabolic syndrome, inflammation, growth factors, androgen receptor, epithelial-stromal interaction, and lifestyle, are discussed. Incomplete overlap of prostatic enlargement with symptoms and obstruction encourages focus on symptoms rather than prostate enlargement and the shifting from surgery to medicine as the treatment of BPH. Several alpha antagonists, including alfuzosin, doxazosin, tamsulosin, and terazosin, have shown excellent efficacy without severe adverse effects. In addition, new alpha antagonists, silodosin and naftopidil, and phosphodiesterase 5 inhibitors are emerging as BPH treatments. In surgical treatment, laser surgery such as photoselective vaporization of the prostate and holmium laser prostatectomy have been introduced to reduce complications and are used as alternatives to transurethral resection of the prostate (TURP) and open prostatectomy. The status of TURP as the gold standard treatment of BPH is still evolving. We review several preclinical and clinical studies about the etiology of BPH and treatment options.

Keyword

Etiology; Lower urinary tract symptoms; Prostatic hyperplasia; Therapy

MeSH Terms

Chronic Disease
Delivery of Health Care
Doxazosin
Humans
Indoles
Inflammation
Intercellular Signaling Peptides and Proteins
Laser Therapy
Lasers, Solid-State
Life Style
Lower Urinary Tract Symptoms
Male
Naphthalenes
Phosphodiesterase 5 Inhibitors
Piperazines
Prazosin
Prostate
Prostatectomy
Prostatic Hyperplasia
Quinazolines
Receptors, Androgen
Sulfonamides
Transurethral Resection of Prostate
Volatilization
Doxazosin
Indoles
Intercellular Signaling Peptides and Proteins
Naphthalenes
Phosphodiesterase 5 Inhibitors
Piperazines
Prazosin
Quinazolines
Receptors, Androgen
Sulfonamides

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