[Prostatic hypertrophy: natural history. Subjective and objective changes during a 6-month period]

Out of 30 patients, referred consecutively, with symptomatic and urodynamic signs of benign hypertrophy of the prostate, 22 were observed for six months as regards symptom scoring, urine flow measurements, serum creatinine and culture from the urine. After the period of observation, 1/3 of the patients no longer wanted operation on account of subjective improvement. The symptom scoring in this group was significantly lower (p less than 0.01) than in the group which was subsequently submitted to operation, on the other hand, no difference in urine flow was demonstrated. No statistically significant alteration in symptom scoring or urine flow was observed during the period of observation but both parameters showed fluctuations. The variations in flow were no greater than in men with normal micturition. None of the patients developed acute retention or involvement of upper urinary tracts during the period of observation. This investigation speaks for a more observing attitude towards treatment of benign hypertrophy of the prostate. In cases where no absolute indications for operative treatment are present (episodes of retention of urine or involvement of the upper urinary tracts), the patient's subjective symptoms constitute an important factor in the indications for operation.