Natural course of human benign prostatic hyperplasia with relation to urinary disturbance

To examine the natural course of human benign prostatic hyperplasia (BPH), cases in health care examination with or without slight urinary symptoms were examined by echography. In comparison with these cases, the size of the prostate was examined in patients who received prostatectomy. Prostatic sizes of health care cases varied widely along with increasing age, but could be divided into two groups: increasing or no-change. According to serial determinations of prostatic sizes in the increasing group, the annual growth rate of the prostate was calculated as 1.65 +/- 1.13 and 0.85 +/- 0.44 g in men < 65 years old and in men > or = 65 years old, respectively. Distribution of prostatic sizes as a function of age in health care cases was similar to that in operated patients, showing that the size was not correlated with urinary symptoms or surgical indication. Since uroflow rates decreased along with increasing age in the no-change group of operated patients, aging was a factor in deterioration of uroflow. Between the increasing and the no-change groups in health care cases, differences were found in total cholesterol and neutral fat in serum, in addition to gamma-seminoprotein; the latter may be due to differences in the size of the prostate. In conclusion, natural course of the prostatic hyperplasia is separated into two groups, increasing and no-change. Occurrence of urinary symptoms does not simply relate to an increase in prostatic weight but, at least in part, to the aging process.