Advancing Basic and Translational Research for Benign Genitourinary Conditions: Intersection of BPH, Male LUTs, and Aging

May 2020 Council

Lead Division/Office

KUH

Point(s) of Contact

Tracy Rankin, Ph.D., M.P.H.; Tamara Bavendam, M.D.

Executive Summary

Benign prostatic hyperplasia (BPH) affects 50% of men over age 50. Ninety percent of men over age 80 become affected. Often men with BPH present with lower urinary tract symptoms (LUTS) and first-line treatment of such symptoms include medical management with 5α-reductase inhibitors to reduce prostate size and α-blockers to relax the urinary sphincter. Surgical therapies to resect the prostate can also be effective. However, many men do not find symptom relief from these prostate-targeted treatments and prostate size is often not correlated with severity of urinary symptoms. This raises the question as to whether male LUTS and BPH are syndromic or whether we should re-examine male LUTS within the framework of separating prostate pathology from bladder pathology. Over the last several years, new insights have emerged regarding the etiology of BPH, as well as the etiology of bladder dysfunction. There have also been significant advances in our understanding of the biology of aging, primarily from model systems. Given these advances, it is an opportune time to incorporate these data into a new understanding of BPH etiology and how prostate pathology relates to male LUTS.