What is a disease? What is the disease clinical benign prostatic hyperplasia (BPH)?

Abstract

Introduction: Though clinical benign prostatic hyperplasia (BPH) is a common disease worldwide, there is still much confusion in the literature and the many clinical guidelines as to its definition. Often the disease is associated with lower urinary tract symptoms (LUTS) and managed according to only symptoms. This leads to undertreatment in some patients with severe bladder outlet obstruction (BOO) with no symptoms, and overtreatment in patients with LUTS but no clinical BPH. Definition of a Disease: Fundamentally, a disease can be defined as an abnormal structure or function or a condition which may cause harm to the organism. Definition of clinical BPH: Thus, clinical BPH can be defined as prostate adenoma/adenomata, causing a varying degree of BOO, which may eventually cause harm to the patients. With this definition, we are then able to differentiate the disease clinical BPH from the many other less common causes of LUTS, and then treat it according to its severity. Diagnosing clinical BPH: Clinical BPH can be diagnosed with non-invasive ultrasound in the clinic, grading it according to the shape (intravesical prostatic protrusion) and size of the prostate. Clinical Significance: Treatment can then be planned according to the disease severity using our staging system that classifies severity according to the presence or absence of significant obstruction and bothersomeness of symptoms. Conclusion: This would lead to better individualised and cost-effective management of the disease clinical BPH.