4.6 Article

The rising worldwide impact of benign prostatic hyperplasia

Journal

BJU INTERNATIONAL
Volume 127, Issue 6, Pages 722-728

Publisher

WILEY
DOI: 10.1111/bju.15286

Keywords

benign prostatic hyperplasia; lower urinary tract symptoms; global health; prostate; quality of life; #UroBPH

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Lower urinary tract symptoms attributed to benign prostatic hyperplasia (LUTS/BPH) have been steadily increasing on a global scale from 1990 to 2017, exceeding the impact of other urological diseases. When stratified by global SDI quintile, a much lower impact of BPH was found in the bottom three quintiles, despite representing a significant portion of the 2017 world population.
Objectives To describe the trend in the impact of lower urinary tract symptoms attributed to benign prostatic hyperplasia (LUTS/BPH) on a global scale using the Global Burden of Disease (GBD) database. Materials and Methods Using the GBD database, worldwide data aggregated from registries and health systems from 1990 to 2017 were filtered for LUTS/BPH diagnoses. Calculation of years lived with disability (YLD) were compared with other urological diseases. YLD were calculated by a standardized method using assigned disability weights. The GBD-defined sociodemographic index (SDI) was used to assess impact of LUTS/BPH by global SDI quintile. Results Global Burden of Disease data over the 1990-2017 study period were summarized and global numbers and trends noted with other urological diseases for comparison. A total of 2 427 334 YLD were attributed to BPH in 2017 alone, almost three times more than those attributed to the next highest urological disease, prostate cancer (843 227 YLD). When stratified by SDI quintile, a much lower impact of BPH was found in the bottom three quintiles, despite this subset representing 66.9% of the 2017 world population. Conclusions Lower urinary tract symptoms attributed to benign prostatic hyperplasia exert a rapidly rising human burden far exceeding other urological diseases. As the population ages and men in a lower SDI enjoy increased life expectancy and decreased competing mortalities, a continually accelerating wave of LUTS/BPH can be forecast. These epidemiological trends have serious implications for the future allocation of resources and the global urological workforce.

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