What is benign prostatic enlargement (BPE)?

Trueman P, Hood SC, Nayak USL et al. Prevalence of lower urinary tract symptoms and self-reported diagnosed 'benign prostatic hyperplasia', and their effect on quality of life in a community-based survey of men in the UK. BJU Int 1999; 83: 410-415.

Wei JT, Calhoun E, Jacobsen SJ. Urologic diseases in America project: benign prostatic hyperplasia. Journal of Urology 2005; 173: 1256-1261.

What causes an enlarged prostate?

Konwar R, Chattopadhyay N, Bid HK Genetic polymorphism and pathogenesis of benign prostatic hyperplasia.. BJU Int. 2008 Aug 5;102(5):536-44.

Neuhouser ML, Kristal AR, Penson DF. Steroid hormones and hormone-related genetic and lifestyle characteristics as risk factors for benign prostatic hyperplasia: review of epidemiologic literature. Urology 2004; 64: 201-11

Parsons JK. Sarma AV. McVary K. Wei JT. Obesity and benign prostatic hyperplasia: clinical connections, emerging etiological paradigms and future directions. Journal of Urology 2009; 182(Supp 6):S27-31

Parsons JK. Modifiable risk factors for benign prostatic hyperplasia and lower urinary tract symptoms: new approaches to old problems. Journal of Urology. 2007; 178: 395-40

Pearson JD, Lei HH, Beaty TH et al. Familial aggregation of bothersome benign prostatic hyperplasia symptoms. Urology 2003; 61: 781-5

Sanda MG, Beaty TH, Stutzman RE, Childs B, Walsh PC. Genetic susceptibility of benign prostatic hyperplasia. J Urol 1994; 152: 115-9

Sarma AV. Parsons JK. McVary K. Wei JT. Diabetes and benign prostatic hyperplasia/lower urinary tract symptoms--what do we know?. Journal of Urology 2009; 182 (supp 6): S32-7.

What are the symptoms?

National Institute for Health and Clinical Excellence. Lower urinary tract symptoms. The management of lower urinary tract symptoms in men. 2010.

Roehrborn CG. BPH progression: concept and key learning from MTOPS, ALTESS, COMBAT, and ALF-ONE. BJU International. 2008; 101 (supp 3): 17-21.

Am I more likely to get prostate cancer if I have an enlarged prostate?

Young JM, Muscatello DJ, Ward JF. Are men with lower urinary tract symptoms at increased risk of prostate cancer? A systematic review and critique of the available evidence. BJU Int 2000; 85:1037-1048.

Schenk JM, Kristal AR, Arnold KB et al. Association of systematic benign prostatic hyperplasia and prostate cancer: results from the prostate cancer prevention trial. American Journal of Epidemiology 2011: 173 (12): 1419-1428.

How might an enlarged prostate affect my life?

Roehrborn CG. BPH progression: concept and key learning from MTOPS, ALTESS, COMBAT, and ALF-ONE. BJU International. 2008; 101 (supp 3): 17-21.

Wei JT, Calhoun E, Jacobsen SJ. Urologic diseases in America project: benign prostatic hyperplasia. Journal of Urology 2005; 173: 1256-1261.

Possible complications of an enlarged prostate

National Institute for Health and Clinical Excellence. Lower urinary tract symptoms. The management of lower urinary tract symptoms in men. 2010.

Diagnosing an enlarged prostate

American Urological Association. 2003 (updated 2006). Guideline on the management of Benign Prostatic Hyperplasia (BPH). Available at http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm [accessed January 2013]

National Institute for Health and Clinical Excellence. Lower urinary tract symptoms. The management of lower urinary tract symptoms in men. 2010.


Treating an enlarged prostate

Lifestyle changes

American Urological Association. 2003 (updated 2006). Guideline on the management of Benign Prostatic Hyperplasia (BPH). Available at http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm [accessed January 2013]

Kaplan ST. Update on the American Urological Association Guidelines for the Treatment of Benign Prostatic Hyperplasia. Reviews in Urology. 2006; 8(Supp 4): S10-S17.

National Institute for Health and Clinical Excellence. Lower urinary tract symptoms. The management of lower urinary tract symptoms in men. 2010.

Oelke M, Bachmann A, Descazeaud A et al. Guidelines on conservative treatment of non-neurogenic male LUTS. European Association of Urology 2010.


Medicines

Tacklind J, Fink HA, MacDonald R et al. Finasteride for benign prostatic hyperplasisa (review). The Cochrane Collaboration 2012.

De la Rosette J, Alivizatos G, Madersbacher S et al. Guidelines on benign prostatic hyperplasia. European Association of Urology 2008. Available at: http://www.uroweb.org/professional-resources/guidelines/ (accessed August 2010)

Electronic medicines compendium. Summary of product characteristics: Avodart. Available at: http://emc.medicines.org.uk/ (accessed Jannuary 2013).

National Institute for Health and Clinical Excellence. Lower urinary tract symptoms. The management of lower urinary tract symptoms in men. 2010.

Nickel JC, Barkin J, Koch C et al. Finasteride monotherapy maintains stable lower urinary tract symptoms in men with benign prostatic hyperplasia following cessation of alpha blockers. Can Urol Assoc J. 2008; 2:16-21.

Oelke M, Bachmann A, Descazeaud A et al. Guidelines on the management of male lower urinary tract symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO). European Association of Urology 2012.

Oelke M, Bachmann A, Descazeaud A et al. Guidelines on treatment of non-neurogenic male LUTS. European Association of Urology 2011.

Roehrborn CG. BPH progression: concept and key learning from MTOPS, ALTESS, COMBAT, and ALF-ONE. BJU International. 2008; 101 (supp 3): 17-21.

Surgery

Oelke M, Bachmann A, Descazeaud A et al. Guidelines on treatment of non-neurogenic male LUTS. European Association of Urology 2011.

Oelke M, Bachmann A, Descazeaud A et al. Guidelines on the management of male lower urinary tract symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO). European Association of Urology 2012.

American Urological Association. 2003 (updated 2006). Guideline on the management of Benign Prostatic Hyperplasia (BPH). Available at http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm [accessed August 2010]

'De la Rosette J, Alivizatos G, Madersbacher S et al. Guidelines on benign prostatic hyperplasia. European Association of Urology 2008. Available at: http://www.uroweb.org/professional-resources/guidelines/ (accessed August 2010)

D S Engeler, C Schwab, M Neyer et al. Bipolar versus monopolar TURP: a prospective controlled study at two urology centers. Prostate Cancer and Prostatic Diseases 2010;13: 285-291.

Hammadeh MY, Madaan S, Hines J, et al. 5-year outcome of a prospective randomized trial to compare transurethral electrovaporization of the prostate and standard transurethral resection. Urology 2003; 61: 1166-1171

Maria G, Brisinda G, Civello IM et al. Relief by botulinum toxin of voiding dysfunction due to benign prostatic hyperplasia: results of a randomized, placebo-controlled study. Urology 2003; 62:259-64

Martin DJ., Mulhall JP. Enlarging the scope of managing benign prostatic hyperplasia: addressing sexual function and quality of life. International Journal of Clinical Practice 2005; 59:579-90.

National Institute for Health and Clinical Excellence. Lower urinary tract symptoms. The management of lower urinary tract symptoms in men. 2010.

National Institute for Health and Clinical Excellence. Interventional procedure overview of Transurethral electrovaporisation of the prostate 2003. Available at http://www.nice.org.uk/nicemedia/live/11108/31070/31070.pdf (accessed January 2013)

Tyson MD, Lerner LB. Safety of holmium laser enucleation of the prostate in anticoagulated patients. Journal of Endourology 2009;23(8):1343-6.

Wilt TJ, Dow JN. Benign prostatic hyperplasia. Part 1 - Diagnosis. BJU Int. 2008; 336: 146-149.