Prostatism: nature of the symptoms

Benign prostatic hyperplasia (BPH) is very common. Almost 80% of men over the age of 70 have at least histological evidence of this process. The clinical prevalence of BPH increases from 10% in the fourth decade to approximately 40% after age 70. Multiple factors are involved in the progression of BPH from a microscopic disease to pathologically enlarged prostate gland. Despite several decades of research, many questions remain unanswered regarding the pathophysiology of benign prostatic enlargement, the most appropriate means of assessing the patient with lower urinary tract symptoms (LUTS), and effective policies of prevention and treatment strategies. Careful patient evaluation, patient selection, and proper technique are undoubtedly the most important factors in ensuring a good response to therapy. Clinical practice guidelines have recently been published, to guide the clinician in management of BPH. This paper will review the subjective and objective assessment tools that are available today.