Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-10T12:06:01.519Z Has data issue: false hasContentIssue false

Diseases of the prostate

Published online by Cambridge University Press:  18 February 2010

Elizabeth Bright*
Affiliation:
Bristol Urological Institute, Southmead Hospital, Bristol, UK
Paul Abrams
Affiliation:
Bristol Urological Institute, Southmead Hospital, Bristol, UK
*
Address for correspondence: Elizabeth Bright, Clinical Research Fellow, Bristol Urological Institute, Southmead Hospital, Bristol BS10 5NB. Email: ebright@doctors.net.uk

Summary

Benign and malignant prostate disease is common in older men and becomes more prevalent with age. Many seek medical help due to bother associated with lower urinary tract symptoms (LUTS). Some fear their LUTS are secondary to prostate cancer or seek advice regarding prostate cancer screening. Furthermore, prostate cancer is now the most common male cancer in the UK. However, not all prostate disease causes LUTS. Equally, not all LUTS are due to a disease of the prostate. Thorough clinical assessment is therefore required to identify urological from non-urological, and benign from malignant causes of LUTS. This review presents a description of the current terminology for diseases of the prostate, the essential clinical assessment and investigations, and a description of the many treatment options currently available for both benign and malignant prostate disease.

Type
Clinical geriatrics
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Logie, J, Clifford, GM, Farmer, RD. Incidence, prevalence and management of lower urinary tract symptoms in men in the UK. BJU Int 2005; 95: 557–62.CrossRefGoogle ScholarPubMed
2Trueman, P, Hood, SC, Nayak, US, Mrazek, MF. 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: 410–15.CrossRefGoogle Scholar
3Abrams, P. New words for old: lower urinary tract symptoms for ‘prostatism’. BNJ 1994; 308: 929–30.Google ScholarPubMed
4Abrams, P, Cardozo, L, Fall, M et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 2002; 21: 167–78.CrossRefGoogle ScholarPubMed
5Berry, SJ, Coffey, DS, Walsh, PC, Ewing, LL. The development of human benign prostatic hyperplasia with age. J Urol 1984; 132: 474–9.CrossRefGoogle ScholarPubMed
6Abrams, HP, Feneley, RC. The significance of the symptoms associated with bladder outflow obstruction. Urol Int 1978; 33: 171–74.CrossRefGoogle Scholar
7Roehrborn, CG, Sech, S, Montoya, J, Rhodes, T, Girman, CJ. Interexaminer reliability and validity of a three-dimensional model to assess prostate volume by digital rectal examination. Urology 2001; 57: 1087–92.CrossRefGoogle ScholarPubMed
8Yap, TL, Cromwell, DA, Brown, C, Van Der Meulen, J, Emberton, M. The relationship between objective frequency-volume chart data and the I-PSS in men with lower urinary tract symptoms. Eur Urol 2007; 52: 811–8.CrossRefGoogle ScholarPubMed
9Abrams, P, Chapple, C, Khoury, S, Roehrborn, C, de la Rosette, J. Evaluation and treatment of lower urinary tract symptoms in older men. J Urol 2009; 181: 1779–87.CrossRefGoogle ScholarPubMed
10Reynard, JM, Yang, Q, Donovan, JL et al. The ICS-‘BPH’ Study: uroflowmetry, lower urinary tract symptoms and bladder outlet obstruction. Br J Urol 1998; 82: 619–23.CrossRefGoogle ScholarPubMed
11Chancellor, MB, Blaivas, JG, Kaplan, SA, Axelrod, S. Bladder outlet obstruction versus impaired detrusor contractility: the role of outflow. J Urol 1991; 145: 810–12.CrossRefGoogle ScholarPubMed
12Abrams, PH, Griffiths, DJ. The assessment of prostatic obstruction from urodynamic measurements and from residual urine. Br J Urol 1979; 51: 129–34.CrossRefGoogle ScholarPubMed
13Barry, MJ, Fowler, FJ Jr, Bin, L, Pitts, JC 3rd, Harris, CJ, Mulley, AG Jr. The natural history of patients with benign prostatic hyperplasia as diagnosed by North American urologists. J Urol 1997; 157: 1014; discussion 4–5.CrossRefGoogle ScholarPubMed
14Ball, AJ, Feneley, RC, Abrams, PH. The natural history of untreated ‘prostatism’. Br J Urol 1981; 53: 613–16.CrossRefGoogle ScholarPubMed
15Thomas, AW, Cannon, A, Bartlett, E, Ellis-Jones, J, Abrams, P. The natural history of lower urinary tract dysfunction in men: minimum 10-year urodynamic follow-up of untreated bladder outlet obstruction. BJU Int 2005; 96: 1301–6.CrossRefGoogle ScholarPubMed
16Wasson, JH, Reda, DJ, Bruskewitz, RC, Elinson, J, Keller, AM, Henderson, WG. A comparison of transurethral surgery with watchful waiting for moderate symptoms of benign prostatic hyperplasia. The Veterans Affairs Cooperative Study Group on Transurethral Resection of the Prostate. N Engl J Med 1995; 332: 7579.CrossRefGoogle Scholar
17Kirby, RS, Pool, JL. Alpha adrenoceptor blockade in the treatment of benign prostatic hyperplasia: past, present and future. Br J Urol 1997; 80: 521–32.CrossRefGoogle ScholarPubMed
18Lowe, F. Alpha-1-adrenoceptor blockade in the treatment of benign prostatic hyperplasia. Prostate Cancer Prostatic Dis 1999; 2: 110–19.CrossRefGoogle ScholarPubMed
19de la Rosette, JJ, Kortmann, BB, Rossi, C, Sonke, GS, Floratos, DL, Kiemeney, LA. Long-term risk of re-treatment of patients using alpha-blockers for lower urinary tract symptoms. J Urol 2002; 167: 1734–39.CrossRefGoogle ScholarPubMed
20Roehrborn, CG, Boyle, P, Nickel, JC, Hoefner, K, Andriole, G. Efficacy and safety of a dual inhibitor of 5-alpha-reductase types 1 and 2 (dutasteride) in men with benign prostatic hyperplasia. Urology 2002; 60: 434–41.CrossRefGoogle ScholarPubMed
21Andersen, JT, Ekman, P, Wolf, H et al. Can finasteride reverse the progress of benign prostatic hyperplasia? A two-year placebo-controlled study. The Scandinavian BPH Study Group. Urology 1995; 46: 631–37.CrossRefGoogle Scholar
22Marberger, MJ. Long-term effects of finasteride in patients with benign prostatic hyperplasia: a double-blind, placebo-controlled, multicenter study. PROWESS Study Group. Urology 1998; 51: 677–86.CrossRefGoogle ScholarPubMed
23McConnell, JD, Bruskewitz, R, Walsh, P et al. The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride Long-Term Efficacy and Safety Study Group. N Engl J Med 1998; 338: 557–63.CrossRefGoogle ScholarPubMed
24Kirby, RS, Roehrborn, C, Boyle, P et al. Efficacy and tolerability of doxazosin and finasteride, alone or in combination, in treatment of symptomatic benign prostatic hyperplasia: the Prospective European Doxazosin and Combination Therapy (PREDICT) trial. Urology 2003; 61: 119–26.CrossRefGoogle ScholarPubMed
25Debruyne, FM, Jardin, A, Colloi, D et al. Sustained-release alfuzosin, finasteride and the combination of both in the treatment of benign prostatic hyperplasia. European ALFIN Study Group. Eur Urol 1998; 34: 169–75.CrossRefGoogle ScholarPubMed
26Wilt, TJ, Ishani, A, Stark, G, MacDonald, R, Lau, J, Mulrow, C. Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA 1998; 280: 1604–9.CrossRefGoogle ScholarPubMed
27Bent, S, Kane, C, Shinohara, K et al. Saw palmetto for benign prostatic hyperplasia. N Engl J Med 2006; 354: 557–66.CrossRefGoogle ScholarPubMed
28Rassweiler, J, Teber, D, Kuntz, R, Hofmann, R. Complications of transurethral resection of the prostate (TURP) – incidence, management, and prevention. Eur Urol 2006; 50: 969–79; discussion 80.CrossRefGoogle ScholarPubMed
29Ramon, J, Lynch, TH, Eardley, I et al. Transurethral needle ablation of the prostate for the treatment of benign prostatic hyperplasia: a collaborative multicentre study. Br J Urol 1997; 80: 128–34; discussion 34–5.CrossRefGoogle ScholarPubMed
30D'Ancona, FC, Francisca, EA, Witjes, WP, Welling, L, Debruyne, FM, De La Rosette, JJ. Transurethral resection of the prostate vs high-energy thermotherapy of the prostate in patients with benign prostatic hyperplasia: long-term results. Br J Urol 1998; 81: 259–64.CrossRefGoogle ScholarPubMed
31Hoffman, RM, MacDonald, R, Monga, M, Wilt, TJ. Transurethral microwave thermotherapy vs transurethral resection for treating benign prostatic hyperplasia: a systematic review. BJU Int 2004; 94: 1031–6.CrossRefGoogle ScholarPubMed
32Madersbacher, S, Schatzl, G, Djavan, B, Stulnig, T, Marberger, M. Long-term outcome of transrectal high-intensity focused ultrasound therapy for benign prostatic hyperplasia. Eur Urol 2000; 37: 687–94.CrossRefGoogle ScholarPubMed
33Schatzl, G, Madersbacher, S, Djavan, B, Lang, T, Marberger, M. Two-year results of transurethral resection of the prostate versus four ‘less invasive’ treatment options. Eur Urol 2000; 37: 695701.CrossRefGoogle ScholarPubMed
34Ruszat, R, Wyler, S, Forster, T et al. Safety and effectiveness of photoselective vaporization of the prostate (PVP) in patients on ongoing oral anticoagulation. Eur Urol 2007; 51: 1031–8; discussion 8–41.CrossRefGoogle ScholarPubMed
35Horasanli, K, Silay, MS, Altay, B, Tanriverdi, O, Sarica, K, Miroglu, C. Photoselective potassium titanyl phosphate (KTP) laser vaporization versus transurethral resection of the prostate for prostates larger than 70 ml: a short-term prospective randomized trial. Urology 2008; 71: 247–51.CrossRefGoogle Scholar
36Bouchier-Hayes, DM, Anderson, P, Van Appledorn, S, Bugeja, P, Costello, AJ. KTP laser versus transurethral resection: early results of a randomized trial. J Endourol 2006; 20: 580–85.CrossRefGoogle ScholarPubMed
37Alivizatos, G, Skolarikos, A, Chalikopoulos, D et al. Transurethral photoselective vaporization versus transvesical open enucleation for prostatic adenomas >80 ml: 12-month results of a randomized prospective study. Eur Urol 2008; 54: 427–37.CrossRefGoogle Scholar
38Naspro, R, Bachmann, A, Gilling, P et al. A review of the recent evidence (2006–2008) for 532-nm photoselective laser vaporisation and holmium laser enucleation of the prostate. Eur Urol 2009; 55: 1345–57.CrossRefGoogle ScholarPubMed
39Ahyai, SA, Lehrich, K, Kuntz, RM. Holmium laser enucleation versus transurethral resection of the prostate: 3-year follow-up results of a randomized clinical trial. Eur Urol 2007; 52: 1456–63.CrossRefGoogle ScholarPubMed
40Wilson, LC, Gilling, PJ, Williams, A et al. A randomised trial comparing holmium laser enucleation versus transurethral resection in the treatment of prostates larger than 40 grams: results at 2 years. Eur Urol 2006; 50: 569–73.CrossRefGoogle ScholarPubMed
41Gupta, N, Sivaramakrishna, , Kumar, R, Dogra, PN, Seth, A. Comparison of standard transurethral resection, transurethral vapour resection and holmium laser enucleation of the prostate for managing benign prostatic hyperplasia of >40 g. BJU Int 2006; 97: 8589.CrossRefGoogle Scholar
42George, NJ. Natural history of localised prostatic cancer managed by conservative therapy alone. Lancet 1988; 1: 494–97.CrossRefGoogle ScholarPubMed
43Chodak, GW, Thisted, RA, Gerber, GS et al. Results of conservative management of clinically localized prostate cancer. N Engl J Med 1994; 330: 242–8.CrossRefGoogle ScholarPubMed
44Albertsen, PC, Hanley, JA, Fine, J. 20-year outcomes following conservative management of clinically localized prostate cancer. JAMA 2005; 293: 2095–101.CrossRefGoogle ScholarPubMed
45Weldon, VE, Tavel, FR, Neuwirth, H. Continence, potency and morbidity after radical perineal prostatectomy. J Urol 1997; 158: 1470–75.CrossRefGoogle ScholarPubMed
46Stolzenburg, JU, Rabenalt, R, Do, M et al. Endoscopic extraperitoneal radical prostatectomy: oncological and functional results after 700 procedures. J Urol 2005; 174: 1271–75; discussion 5.CrossRefGoogle ScholarPubMed
47Dahl, DM, Barry, MJ, McGovern, FJ, Chang, Y, Walker-Corkery, E, McDougal, WS. A prospective study of symptom distress and return to baseline function after open versus laparoscopic radical prostatectomy. J Urol 2009; 182: 956–65.CrossRefGoogle ScholarPubMed
48Eckman, MH, Ying, J, Hertzfeld, K, Kumar, N, Barrett, W. Longitudinal analysis of genitourinary and bowel symptoms in prostate cancer patients following brachytherapy. Am J Clin Oncol 2009 (Epub ahead of print, 24 July).Google Scholar
49Colberg, JW, Decker, RH, Khan, AM, McKeon, A, Wilson, LD, Peschel, RE. Surgery versus implant for early prostate cancer: results from a single institution, 1992–2005. Cancer J 2007; 13: 229–32.CrossRefGoogle ScholarPubMed
50Polascik, TJ, Pound, CR, DeWeese, TL, Walsh, PC. Comparison of radical prostatectomy and iodine 125 interstitial radiotherapy for the treatment of clinically localized prostate cancer: a 7-year biochemical (PSA) progression analysis. Urology 1998; 51: 884–89; discussion 9–90.CrossRefGoogle ScholarPubMed