Recent reviews, reports and research about risk factors related to Benign Prostatic Hyperplasia (BPH) and LUTS

Try sitting if you have an enlarged prostate and LUTS. Men with urination problems as a result of enlarged prostate may be better off sitting rather than standing to urinate, according to a recent systematic review and meta-analysis. In a 25 July 2014 article in Renal & Urology News, Jody Charnow states: “Ype de Jong, MD, and colleagues at Leiden University Medical Center in Leiden, The Netherlands, analyzed data from 11 studies that included healthy men and those with lower urinary tract symptoms (LUTS). Among men with LUTS, a sitting position during urination was associated with a significantly lower post- void residual volume (PVR) compared with standing, the researchers reported...” Read the article here or here: http://tinyurl.com/mpot7xv


The link between benign prostatic hyperplasia (BPH) and prostate cancer
. Authors: David D. Ørsted, Stig E. Bojesen. Nature Reviews Urology 10, 49-54 (January 2013) doi:10.1038/nrurol.2012.192 Author's abstract: Benign prostatic hyperplasia (BPH) and prostate cancer are among the most common diseases of the prostate gland and represent significant burdens for patients and health-care systems in many countries. The two diseases share traits such as hormone-dependent growth and response to antiandrogen therapy. Furthermore, risk factors such as prostate inflammation and metabolic disruption have key roles in the development of both diseases. Despite these commonalities, BPH and prostate cancer exhibit important differences in terms of histology and localization. Although large-scale epidemiological studies have shown that men with BPH have an increased risk of prostate cancer and prostate-cancer-related mortality, it remains unclear whether this association reflects a causal link, shared risk factors or pathophysiological mechanisms, or detection bias upon statistical analysis. Establishing BPH as a causal factor for prostate cancer development could improve the accuracy of prognostication and expedite intervention, potentially reducing the number of men who die from prostate cancer.

No reduction in Quality of Life for long-term use of Finasteride. The 5-alpha-reductase inhibitor Finasteride has been used for the alleviation of benign prostatic hyperplasia (BPH). In a 12 September 2012 article by Megan Brooks, the results of a 7-year Prostate Cancer Prevention Trial (PCPT) are reported: http://www.medscape.com/viewarticle/770818 The trial was undertaken by a team led by Dr Carol M Moinpour of the Fred Hutchinson Cancer Research Center in Seattle. The Brooks' article indicated that there was a "... 25% reduction in the prevalence of prostate cancer and about a 40% reduction in the occurrence of symptomatic benign prostatic hypertrophy (BPH)" and "... no statistically significant affect on these three health-related quality of life domains": physical functioning, mental health and vitality.

Effect of dutasteride on the risk of prostate cancer. An article by G L Andriole el al in The New England Journal of Medicine, 2010 362:1192-1202. The authors concluded that “...among men at increased risk for prostate cancer and for benign prostatic hyperplasia, dutasteride reduced the risk of prostate cancers and precursor lesions and improved many outcomes related to benign prostatic hyperplasia. Dutasteride may be considered as a treatment option for men who are at increased risk for prostate cancer.” The article can be viewed here or downloaded as a 426 KB PDF file from here. Note that while use of Dutasteride for the treatment of benign prostatic hyperplasia (BPH) has been approved since 2002 by the USA’s FDA and Australia’s TGA (and from February 2011 was listed with a streamlined PBS authorisation code), in December 2010 the FDA rejected dutasteride as a drug for the indication of reducing the risk of prostate cancer (see article here).