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. 2021 Jun;127(6):722-728.
doi: 10.1111/bju.15286. Epub 2020 Nov 21.

The rising worldwide impact of benign prostatic hyperplasia

Bryn M Launer  1 , Kevin T McVary  2 , William A Ricke  3 , Granville L Lloyd  4
Affiliations

The rising worldwide impact of benign prostatic hyperplasia

Bryn M Launer et al. BJU Int. 2021 Jun.

Abstract

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.

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

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Conflict of interest statement

Conflicts of Interest

Bryn Launer, William Ricke and Granville Lloyd have nothing to disclose. Kevin McVary declares the following: having served as a scientific study or trial, and principal investigator for NxThera, a principal investigator and consultant for NIDDK and Olympus, a principal investigator for Astellas, a principal investigator and fellowship grant consultant for Boston Scientific (formerly AMS), and being a patent holder for A1 Thermal-Actived Penile Prosthesis.

Figures

Fig. 1
Fig. 1
The global increase in years lived with disease (YLD) attributed to BPH over the previous 27 years, reported in (A) absolute numbers and (B) rate per 100 000 persons.
Fig. 2
Fig. 2
The global increase in years lived with disease (YLD) attributed to BPH over the previous 27 years compared to major urological diseases, reported in absolute numbers. (LUTS/BPH disability weight = 0.067).
Fig. 3
Fig. 3
The global increase in years lived with disease (YLD) attributed to BPH over the previous 27 years divided by sociodemographic index (SDI) quintile, reported in absolute numbers.
Fig. 4
Fig. 4
Percentage change in global population of men over time as compared to first-world urological workforce trends.
See this image and copyright information in PMC

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