Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, USA.
Department of Urology, Sydney Adventist Hospital Clinical School, University of Sydney, Sydney, New South Wales, Australia.
Nat Rev Dis Primers. 2016 May 5;2:16031. doi: 10.1038/nrdp.2016.31.
Benign prostatic hyperplasia (BPH), which causes lower urinary tract symptoms (LUTS), is a common diagnosis among the ageing male population with increasing prevalence. Many risks factors, both modifiable and non-modifiable, can increase the risk of development and progression of BPH and LUTS. The symptoms can be obstructive (resulting in urinary hesitancy, weak stream, straining or prolonged voiding) or irritative (resulting in increased urinary frequency and urgency, nocturia, urge incontinence and reduced voiding volumes), or can affect the patient after micturition (for example, postvoid dribble or incomplete emptying). BPH occurs when both stromal and epithelial cells of the prostate in the transitional zone proliferate by processes that are thought to be influenced by inflammation and sex hormones, causing prostate enlargement. Patients with LUTS undergo several key diagnostic investigations before being diagnosed with BPH. Treatment options for men with BPH start at watchful waiting and progress through medical to surgical interventions. For the majority of patients, the starting point on the treatment pathway will be dictated by their symptoms and degree of bother.
良性前列腺增生症（BPH）会引起下尿路症状（LUTS），是老年男性的常见疾病，其发病率呈上升趋势。许多可改变和不可改变的危险因素会增加 BPH 和 LUTS 的发生和进展风险。其症状既可以是阻塞性的（表现为尿踌躇、尿流弱、费力或排尿时间延长），也可以是刺激性的（表现为尿频、尿急、急迫性尿失禁和排尿量减少），还会影响患者的排尿后情况（例如，排尿后滴沥或排空不彻底）。BPH 是由于前列腺移行区的基质和上皮细胞增生，这一过程被认为受炎症和性激素的影响，导致前列腺增大。出现 LUTS 的患者在被诊断为 BPH 之前要进行多项关键诊断性检查。BPH 患者的治疗选择从观察等待开始，然后逐步发展为药物治疗到手术干预。对于大多数患者，治疗途径的起点将由他们的症状和困扰程度决定。
