[Epidemiology of benign prostatic syndrome. Associated risks and management data in German men over age 50]

In Germany, the condition of lower urinary tract symptoms (LUTS)/benign prostatic hypertrophy (BPH) is referred to as benign prostatic syndrome (BPS), reflecting the vast variation and interdependency of symptom severity, prostate volume, and micturition parameters. BPS is a progredient disease with distinguished risk factors for progression: age, symptom severity, prostate volume, and degree of obstruction. Therapy in Germany is provided by general practitioners and urologists. From a representative survey in Germany (the Herner BPS study), it can be calculated that among 11,674,900 men over 50 years of age, 3,230,000 have an enlarged prostate (benign prostatic enlargement, with prostate volume >25 ml). Moreover, 1,500,000 men with significant symptoms [International Prostate Symptom Score (IPSS) >7] have a prostate volume >40 ml, representing BPS with a high risk of progression, and 2,080,000 men show signs of obstruction (defined as Qmax <10 ml/s). Thirty percent of men with significant symptoms (IPSS >7) are treated medically, and an additional 20% have been prescribed medication for LUTS at least once. Ten percent of men in Germany are treated without evidence of symptoms. Based on published parameters of progression, 18.5% of men over 50 years of age will experience symptomatic progression (IPSS increase above four score points). Overall progression (symptomatic, surgery, or urinary retention) was 27% in 5 years. These findings show that BPS is a disease with substantial future effects on the German healthcare system.