Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia (LUTS/BPH): More Than Treating Symptoms?  Mark J. Speakman  European Urology Supplements  Volume 7, Issue 11, Pages 680-689 (November 2008) DOI: 10.1016/j.eursup.2008.08.003 Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 1 Impact of baseline prostate-specific antigen (PSA) levels and prostate volume on the risk of developing acute urinary retention (AUR). Data are obtained by pooling the results of three identical 2-yr multinational non-US finasteride-controlled trials (SCAndinavian Reduction of the Prostate study [SCARP], PROscar Safety Plus Efficacy Canadian Two-year study [PROSPECT], and PROscar Worldwide Efficacy and Safety Study [PROWESS]) in men with mild-to-moderate symptomatic benign prostatic hyperplasia (BPH) [27]. The percentage of patients in the placebo group developing AUR during follow-up is depicted as a function of baseline PSA level and prostate volume. High baseline PSA levels and large prostate volumes significantly increase the incidence of spontaneous AUR. European Urology Supplements 2008 7, 680-689DOI: (10.1016/j.eursup.2008.08.003) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 2 Impact of acute and/or chronic inflammation on the risk of clinical progression of benign prostatic hyperplasia (BPH): results from the Medical Therapy Of Prostatic Symptoms (MTOPS) study [30]. The percentage of patients experiencing overall clinical progression, acute urinary retention (AUR), or BPH-related surgery during follow-up (mean duration 4.5 yr) is compared between patient groups with (n=544) and without inflammation (n=653) on baseline biopsies. The risk of AUR is significantly increased in patients with baseline inflammation, while overall clinical progression also tends to be increased in these patients. European Urology Supplements 2008 7, 680-689DOI: (10.1016/j.eursup.2008.08.003) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 3 Impact of lower urinary tract symptoms (LUTS) on the quality of life (QoL) of both patients and their partners: (a) Comparison of impact on QoL of LUTS and different stages of prostate cancer (PCa) [42]. Total International Prostate Symptom Score (IPSS) and total Functional Assessment of Cancer Therapy–General (FACT–G) score (QoL questionnaire) are compared among a control population, patients with moderate or severe LUTS (IPSS score in parentheses), and patients in different clinical stages of prostate cancer (T1–T2: organ-confined prostate cancer; T3–T4: metastatic prostate cancer). Severe LUTS cause a similar decrease in the QoL as 80% advanced prostate cancer. (b) Impact of symptomatic LUTS/BPH (benign prostatic hyperplasia) on QoL of patients’ partners. The percentage of partners affected by several QoL-related issues is depicted (n=90). QoL is considerably affected in partners of LUTS/BPH patients [44]. European Urology Supplements 2008 7, 680-689DOI: (10.1016/j.eursup.2008.08.003) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 4 Opinions of 382 urologists participating in a Web-based survey on the management of a patient with a first presentation of lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). The percentage of respondents preferring a certain treatment option is depicted. The patient's bother and quality of life (QoL) appear to be important drivers in taking treatment decisions for LUTS/BPH. European Urology Supplements 2008 7, 680-689DOI: (10.1016/j.eursup.2008.08.003) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 5 Overview of four main drivers for taking individual treatment decisions in the management of lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). European Urology Supplements 2008 7, 680-689DOI: (10.1016/j.eursup.2008.08.003) Copyright © 2008 European Association of Urology Terms and Conditions