BPH: Social Impact and Patient's Perspective

Benign prostatic hyperplasia (BPH) is a common condition in ageing men and although not a life-threatening disease, it can affect quality of life (QOL) to differing degrees. BPH progressively decreases patient self-esteem and lower urinary tract symptoms have also been shown to affect a patient's perceived sexuality. It has been shown that the impact of BPH on QOL is comparable to other disease conditions such as epilepsy requiring surgery and asthma, but worse, in certain aspects, than chronic obstructive pulmonary disease. With regard to the effect that BPH has on the patient's partner, the morbidity reported was due to sleep disturbance, disruption of social life, psychological burden, inadequate sex life, and fear of surgery or prostate cancer. Factors that influence a patient's desire to seek treatment have been identified and include bother, interference with daily activities, symptom frequency, worry, and embarrassment; patients also have a major concern about acute urinary retention (AUR) and BPH-related surgery. The reasons patients with BPH chose one therapy over another have been studied and it appears that patients prefer rapid symptom improvement, reduction in prostate size, no side-effects, and a decrease in the risk of AUR and surgery. The strongest influence was side-effects and the most important benefit was reduction in prostate size. Physicians clearly influence the final treatment decision, but they should be aware of patient preferences and consider them when they discuss treatment options with the patient.