title: The natural history of patients with benign prostatic hyperplasia as diagnosed by North American urologists.
abstract: OBJECTIVE
  We defined outcomes for men with a clinical diagnosis of benign prostatic hyperplasia.
  
  
  METHODS
  We followed for 4 years 500 candidates for elective prostatectomy treated nonoperatively in 5 North American urology practices.
  
  
  RESULTS
  There were 371 survivors with complete data at 4 years. Of 60 men with mild, 245 with moderate and 66 with severe baseline symptoms 10, 24 and 39%, respectively, had undergone surgery; 27, 31 and 27%, respectively, were on pharmacological therapy, and 63, 45 and 33%, respectively, were off active treatment at 4 years. Mild or moderate symptoms were noted at 4 years in 83, 59 and 23% of the patients, respectively, while 17, 41 and 77%, respectively, had severe symptoms or had undergone surgery.
  
  
  CONCLUSIONS
  Outcomes for men with a clinical diagnosis of benign prostatic hyperplasia depend on initial symptom severity. However, the course of symptoms also varies among patients even with the same initial symptom severity.
authors.affiliation: Medical Practices Evaluation Center, Massachusetts General Hospital, Boston, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Barry
authors.forename: F J
authors.initials: FJ
authors.lastname: Fowler
authors.forename: L
authors.initials: L
authors.lastname: Bin
authors.forename: J C
authors.initials: JC
authors.lastname: Pitts
authors.forename: C J
authors.initials: CJ
authors.lastname: Harris
authors.forename: A G
authors.initials: AG
authors.lastname: Mulley
mesh_terms: D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009656:North America; D011470:Prostatic Hyperplasia / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D014572:Urology