title: Epidemiology and etiology of benign prostatic hyperplasia and bladder outlet obstruction.
abstract: Benign prostatic hyperplasia (BPH) is a histological diagnosis associated with unregulated proliferation of connective tissue, smooth muscle and glandular epithelium. BPH may compress the urethra and result in anatomic bladder outlet obstruction (BOO); BOO may present as lower urinary tract symptoms (LUTS), infections, retention and other adverse events. BPH and BOO have a significant impact on the health of older men and health-care costs. As the world population ages, the incidence and prevalence of BPH and LUTS have increased rapidly. Although non-modifiable risk factors - including age, genetics and geography - play significant roles in the etiology of BPH and BOO, recent data have revealed modifiable risk factors that present new opportunities for treatment and prevention, including sex steroid hormones, the metabolic syndrome and cardiovascular disease, obesity, diabetes, diet, physical activity and inflammation. We review the natural history, definitions and key risk factors of BPH and BOO in epidemiological studies.
authors.affiliation: Department of Urology, Moores UCSD Cancer Center, University of California, San Diego, and Section of Surgery, VA San, USA.
authors.forename: Nishant D
authors.initials: ND
authors.lastname: Patel
authors.affiliation: Department of Urology, Moores UCSD Cancer Center, University of California, San Diego, and Section of Surgery, VA San, USA.
authors.forename: J Kellogg
authors.initials: JK
authors.lastname: Parsons
keywords: Etiology; benign prostatic hyperplasia; bladder outflow obstruction; epidemiology; genetics; public health
references.citation: Eur Urol. 2008 Apr;53(4):819-25; discussion 825-7
references.pmid: 17826889
references.citation: Asian Pac J Cancer Prev. 2010;11(4):1067-72
references.pmid: 21133626
references.citation: Acta Histochem. 1998 Nov;100(4):439-49
references.pmid: 9842422
references.citation: J Urol. 2009 Feb;181(2):710-6
references.pmid: 19091352
references.citation: Urol Clin North Am. 2009 Nov;36(4):443-59, v-vi
references.pmid: 19942044
references.citation: Am J Epidemiol. 2008 Dec 15;168(12):1416-24
references.pmid: 18945688
references.citation: Epidemiology. 2006 Jul;17(4):419-27
references.pmid: 16699472
references.citation: Eur Urol. 2012 Mar;61(3):560-70
references.pmid: 22119157
references.citation: J Androl. 2003 May-Jun;24(3):299-311
references.pmid: 12721204
references.citation: Urology. 2003 May;61(5):956-60
references.pmid: 12736015
references.citation: J Clin Epidemiol. 2001 Sep;54(9):935-44
references.pmid: 11520654
references.citation: J Androl. 1999 Jul-Aug;20(4):474-80
references.pmid: 10452590
references.citation: J Urol. 2012 Aug;188(2):496-501
references.pmid: 22704110
references.citation: J Urol. 2006 May;175(5):1937-42
references.pmid: 16600802
references.citation: Eur Urol. 2006 Sep;50(3):549-54
references.pmid: 16442205
references.citation: BJU Int. 2010 Jun;105(11):1554-9
references.pmid: 20002438
references.citation: BJU Int. 2009 Jul;104(1):63-8
references.pmid: 19154508
references.citation: Urology. 2006 Oct;68(4):804-9
references.pmid: 17070357
references.citation: J Urol. 1996 Feb;155(2):595-600
references.pmid: 8558668
references.citation: Curr Opin Urol. 2005 Jan;15(1):35-8
references.pmid: 15586028
references.citation: J Clin Endocrinol Metab. 2007 May;92(5):1659-65
references.pmid: 17299062
references.citation: Prostate. 1990;17(3):241-6
references.pmid: 1700403
references.citation: J Urol. 2009 Dec;182(6 Suppl):S32-7
references.pmid: 19846144
references.citation: J Clin Endocrinol Metab. 1999 Oct;84(10):3613-9
references.pmid: 10523004
references.citation: J Urol. 2010 May;183(5):1915-20
references.pmid: 20303101
references.citation: J Urol. 2011 May;185(5):1793-803
references.pmid: 21420124
references.citation: Urology. 2008 Aug;72(2):318-21
references.pmid: 18554695
references.citation: Eur Urol. 2013 Jun;63(6):1115-21
references.pmid: 23541458
references.citation: Eur Urol. 2012 Aug;62(2):234-41
references.pmid: 22459892
references.citation: J Urol. 2007 Nov;178(5):2181-5
references.pmid: 17870113
references.citation: Urology. 2006 Dec;68(6):1198-205
references.pmid: 17169643
references.citation: J Urol. 2009 Oct;182(4):1458-62
references.pmid: 19683305
references.citation: J Nutr. 2011 Feb;141(2):267-73
references.pmid: 21178086
references.citation: J Urol. 1997 Aug;158(2):481-7
references.pmid: 9224329
references.citation: BJU Int. 2012 Jan;109(1):84-7
references.pmid: 21615853
references.citation: Circulation. 2003 Sep 30;108(13):1541-5
references.pmid: 14517149
references.citation: Eur Urol. 2003 Apr;43(4):374-80
references.pmid: 12667718
references.citation: Aging Male. 2013 Jun;16(2):48-51
references.pmid: 23480623
references.citation: Urology. 1994 Nov;44(5):646-50
references.pmid: 7526523
references.citation: Eur Urol. 2008 Jun;53(6):1228-35
references.pmid: 18358592
references.citation: Prostate Cancer Prostatic Dis. 2013 Sep;16(3):260-5
references.pmid: 23648398
references.citation: Eur Urol. 2011 Dec;60(6):1173-80
references.pmid: 21802828
references.citation: Eur Urol. 2001 Sep;40(3):256-63; discussion 264
references.pmid: 11684840
references.citation: Am J Epidemiol. 2005 Nov 1;162(9):898-906
references.pmid: 16177142
references.citation: Am J Epidemiol. 2006 Oct 15;164(8):760-8
references.pmid: 16905643
references.citation: Urology. 2004 Nov;64(5):959-65
references.pmid: 15533486
references.citation: Eur Urol. 2008 Dec;54(6):1379-84
references.pmid: 18036719
references.citation: J Urol. 1997 Jan;157(1):10-4; discussion 14-5
references.pmid: 8976204
references.citation: J Urol. 2009 Oct;182(4):1463-8
references.pmid: 19683313
references.citation: Invest New Drugs. 2012 Apr;30(2):582-93
references.pmid: 21181231
references.citation: J Urol. 1994 Jul;152(1):115-9
references.pmid: 7515446
references.citation: Urology. 2003 Apr;61(4):781-5
references.pmid: 12670565
references.citation: N Engl J Med. 2003 Dec 18;349(25):2387-98
references.pmid: 14681504
references.citation: J Med Assoc Thai. 2002 Mar;85(3):356-60
references.pmid: 12117026
references.citation: Urol Clin North Am. 1990 Aug;17(3):477-86
references.pmid: 1695776
references.citation: J Urol. 2007 Aug;178(2):395-401
references.pmid: 17561143
references.citation: Prostate. 2005 Jan 1;62(1):27-33
references.pmid: 15389816
references.citation: MMWR Morb Mortal Wkly Rep. 2003 Feb 14;52(6):101-4, 106
references.pmid: 12645839
references.citation: BJU Int. 2008 Mar;101 Suppl 3:17-21
references.pmid: 18307681
references.citation: J Urol. 2008 May;179(5 Suppl):S75-80
references.pmid: 18405761
references.citation: Genet Test Mol Biomarkers. 2012 Aug;16(8):835-40
references.pmid: 22731640
references.citation: J Urol. 2013 Jan;189(1 Suppl):S102-6
references.pmid: 23234610
references.citation: Am J Epidemiol. 2008 Apr 15;167(8):925-34
references.pmid: 18263602
references.citation: J Urol. 1997 Mar;157(3):876-9
references.pmid: 9072590
references.citation: Prostate. 2007 Dec 1;67(16):1816-24
references.pmid: 17935157
references.citation: J Urol. 2005 Apr;173(4):1256-61
references.pmid: 15758764
references.citation: Curr Opin Urol. 2011 Jan;21(1):1-4
references.pmid: 21045705
references.citation: Urology. 1995 Sep;46(3 Suppl A):34-40
references.pmid: 7544515
references.citation: Urology. 2003 Jun;61(6):1123-8
references.pmid: 12809878
references.citation: Am J Epidemiol. 2003 May 15;157(10):906-14
references.pmid: 12746243
references.citation: BJU Int. 2008 Feb;101(3):313-8
references.pmid: 18005202
references.citation: BJU Int. 2004 Aug;94(3):332-4
references.pmid: 15291862
references.citation: J Urol. 2010 Sep;184(3):1040-4
references.pmid: 20643424
references.citation: BJU Int. 1999 Dec;84(9):976-81
references.pmid: 10571623
references.citation: Urology. 2012 Jan;79(1):102-8
references.pmid: 22112286
references.citation: J Clin Invest. 2004 Dec;114(12):1752-61
references.pmid: 15599400