Lower urinary tract symptoms in men

John M Hollingsworth, Timothy J Wilt, John M Hollingsworth, Timothy J Wilt

Abstract

Benign prostatic hyperplasia (BPH) is a highly prevalent and costly condition that affects older men worldwide. Many affected men develop lower urinary tract symptoms, which can have a negative impact on their quality of life. In the past, transurethral resection of the prostate (TURP) was the mainstay of treatment. However, several efficacious drug treatments have been developed, which have transformed BPH from an acute surgical entity to a chronic medical condition. Specifically, multiple clinical trials have shown that α adrenoceptor antagonists can significantly ameliorate lower urinary tract symptoms. Moreover, 5α reductase inhibitors, alone or combined with an α adrenoceptor antagonist, can reverse the natural course of BPH, reducing the risk of urinary retention and the need for surgical intervention. Newer medical regimens including the use of antimuscarinic agents or phosphodiesterase type 5 inhibitors, have shown promise in men with predominantly storage symptoms and concomitant erectile dysfunction, respectively. For men who do not adequately respond to conservative measures or pharmacotherapy, minimally invasive surgical techniques (such as transurethral needle ablation, microwave thermotherapy, and prostatic urethral lift) may be of benefit, although they lack the durability of TURP. A variety of laser procedures have also been introduced, whose improved hemostatic properties abrogate many of the complications associated with traditional surgery.

Conflict of interest statement

Competing interests: We have read and understood BMJ policy on declaration of interests and declare the following interests: Funding from the Agency for Healthcare Research and Quality (1K08HS020927-01A1 to JMH).

© BMJ Publishing Group Ltd 2014.

Figures

https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4784585/bin/holj015747.f1_default.jpg
Fig 1 International prostate symptom score (IPSS). Use the interactive symptom score tool at http://www.bmj.com/content/349/bmj.g4474/infographic
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4784585/bin/holj015747.f2_default.jpg
Fig 2 Cumulative incidence of progression of benign prostatic hyperplasia in men with moderate to severe symptoms at baseline. Progression was defined by an increase of at least four points in the American Urological Association symptom index score, acute urinary retention, incontinence, renal insufficiency, or recurrent urinary tract infections.
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4784585/bin/holj015747.f3_default.jpg
Fig 3 Cumulative incidence of acute urinary retention (A) and invasive treatment (B) for benign prostatic hyperplasia

References

    1. Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol 1984;132:474-9.
    1. Abrams P. LUTS, BPH, BPE, BPO: a plea for the logical use of correct terms. Rev Urol 1999;1:65.
    1. Wei JT, Calhoun E, Jacobsen SJ. Urologic diseases in america project: benign prostatic hyperplasia. J Urol 2008;179(5 suppl):S75-80.
    1. Moyad MA, Lowe FC. Educating patients about lifestyle modifications for prostate health. Am J Med 2008;121(8 suppl 2):S34-42.
    1. Parsons JK, Mougey J, Lambert L, Wilt TJ, Fink HA, Garzotto M, et al. Lower urinary tract symptoms increase the risk of falls in older men. BJU Int 2009;104:63-8.
    1. Hollingsworth JM, Hollenbeck BK, Daignault S, Kim SP, Wei JT. Differences in initial benign prostatic hyperplasia management between primary care physicians and urologists. J Urol 2009;182:2410-4.
    1. Isaacs JT, Coffey DS. Etiology and disease process of benign prostatic hyperplasia. Prostate Suppl 1989;2:33-50.
    1. Haylen BT, Ashby D, Sutherst JR, Frazer MI, West CR. Maximum and average urine flow rates in normal male and female populations—the Liverpool nomograms. Br J Urol 1989;64:30-8.
    1. Girman CJ, Panser LA, Chute CG, Oesterling JE, Barrett DM, Chen CC, et al. Natural history of prostatism: urinary flow rates in a community-based study. J Urol 1993;150:887-92.
    1. Oesterling JE, Jacobsen SJ, Chute CG, Guess HA, Girman CJ, Panser LA, et al. Serum prostate-specific antigen in a community-based population of healthy men. Establishment of age-specific reference ranges. JAMA 1993;270:860-4.
    1. Chute CG, Panser LA, Girman CJ, Oesterling JE, Guess HA, Jacobsen SJ, et al. The prevalence of prostatism: a population-based survey of urinary symptoms. J Urol 1993;150:85-9.
    1. Bosch JL, Hop WC, Kirkels WJ, Schroder FH. Natural history of benign prostatic hyperplasia: appropriate case definition and estimation of its prevalence in the community. Urology 1995;46(3 suppl A):34-40.
    1. Warren K, Burden H, Abrams P. Lower urinary tract symptom: still too much focus on the prostate? Curr Opin Urol 2014;24:3-9.
    1. Coyne KS, Sexton CC, Thompson CL, Milsom I, Irwin D, Kopp ZS, et al. The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study. BJU Int 2009;104:352-60.
    1. Chang RT, Kirby R, Challacombe BJ. Is there a link between BPH and prostate cancer? Practitioner 2012;256:13-6, 12.
    1. Gillatt D, Reynard JM. What is the “normal range” for prostate-specific antigen? Use of a receiver operating characteristic curve to evaluate a serum marker. Br J Urol 1995;75:341-6.
    1. Giovannucci E, Rimm EB, Chute CG, Kawachi I, Colditz GA, Stampfer MJ, et al. Obesity and benign prostatic hyperplasia. Am J Epidemiol 1994;140:989-1002.
    1. Dahle SE, Chokkalingam AP, Gao YT, Deng J, Stanczyk FZ, Hsing AW. Body size and serum levels of insulin and leptin in relation to the risk of benign prostatic hyperplasia. J Urol 2002;168:599-604.
    1. Seim A, Hoyo C, Ostbye T, Vatten L. The prevalence and correlates of urinary tract symptoms in Norwegian men: the HUNT study. BJU Int 2005;96:88-92.
    1. Parsons JK, Carter HB, Partin AW, Windham BG, Metter EJ, Ferrucci L, et al. Metabolic factors associated with benign prostatic hyperplasia. J Clin Endocrinol Metab 2006;91:2562-8.
    1. Cohen P, Peehl DM, Rosenfeld RG. The IGF axis in the prostate. Horm Metab Res 1994;26:81-4.
    1. Meigs JB, Mohr B, Barry MJ, Collins MM, McKinlay JB. Risk factors for clinical benign prostatic hyperplasia in a community-based population of healthy aging men. J Clin Epidemiol 2001;54:935-44.
    1. Hammarsten J, Hogstedt B. Hyperinsulinaemia as a risk factor for developing benign prostatic hyperplasia. Eur Urol 2001;39:151-8.
    1. Wichi RB, De Angelis K, Jones L, Irigoyen MC. A brief review of chronic exercise intervention to prevent autonomic nervous system changes during the aging process. Clinics (Sao Paulo) 2009;64:253-8.
    1. Barry MJ, Fowler FJ, Jr., O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, et al. The American Urological Association symptom index for benign prostatic hyperplasia. The measurement committee of the American Urological Association. J Urol 1992;148:1549-57; discussion 1564.
    1. Barry MJ, Williford WO, Chang Y, Machi M, Jones KM, Walker-Corkery E, et al. Benign prostatic hyperplasia specific health status measures in clinical research: how much change in the American Urological Association symptom index and the benign prostatic hyperplasia impact index is perceptible to patients? J Urol 1995;154:1770-4.
    1. Maserejian NN, Wager CG, Giovannucci EL, Curto TM, McVary KT, McKinlay JB. Intake of caffeinated, carbonated, or citrus beverage types and development of lower urinary tract symptoms in men and women. Am J Epidemiol 2013;177:1399-410.
    1. Soda T, Masui K, Okuno H, Terai A, Ogawa O, Yoshimura K. Efficacy of nondrug lifestyle measures for the treatment of nocturia. J Urol 2010;184:1000-4.
    1. Brown CT, Yap T, Cromwell DA, Rixon L, Steed L, Mulligan K, et al. Self management for men with lower urinary tract symptoms: randomised controlled trial. BMJ 2007;334:25.
    1. Wilt TJ, Howe W, MacDonald R. Terazosin for treating symptomatic benign prostatic obstruction: a systematic review of efficacy and adverse effects. BJU Int 2002;89:214-25.
    1. McConnell JD, Bruskewitz R, Walsh P, Andriole G, Lieber M, Holtgrewe HL, et al. The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride Long-Term Efficacy and Safety Study Group. N Engl J Med 1998;338:557-63.
    1. Filson CP, Hollingsworth JM, Clemens JQ, Wei JT. The efficacy and safety of combined therapy with alpha-blockers and anticholinergics for men with benign prostatic hyperplasia: a meta-analysis. J Urol 2013;190:2153-60.
    1. Gacci M, Corona G, Salvi M, Vignozzi L, McVary KT, Kaplan SA, et al. A systematic review and meta-analysis on the use of phosphodiesterase 5 inhibitors alone or in combination with alpha-blockers for lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol 2012;61:994-1003.
    1. Caine M, Raz S, Zeigler M. Adrenergic and cholinergic receptors in the human prostate, prostatic capsule and bladder neck. Br J Urol 1975;47:193-202.
    1. Forray C, Bard JA, Wetzel JM, Chiu G, Shapiro E, Tang R, et al. The alpha 1-adrenergic receptor that mediates smooth muscle contraction in human prostate has the pharmacological properties of the cloned human alpha 1c subtype. Mol Pharmacol 1994;45:703-8.
    1. Lepor H, Shapiro E. Characterization of alpha1 adrenergic receptors in human benign prostatic hyperplasia. J Urol 1984;132:1226-9.
    1. Shapiro E, Lepor H. Alpha 2 adrenergic receptors in hyperplastic human prostate: identification and characterization using [3H] rauwolscine. J Urol 1986;135:1038-42.
    1. American Urological Association Guideline. Management of benign prostatic hyperplasia (BPH). Revised. 2010. .
    1. European Association of Urology. Guidelines on the treatment of non-neurogenic male LUTS, 2011. . .
    1. Roehrborn CG, Van Kerrebroeck P, Nordling J. Safety and efficacy of alfuzosin 10 mg once-daily in the treatment of lower urinary tract symptoms and clinical benign prostatic hyperplasia: a pooled analysis of three double-blind, placebo-controlled studies. BJU Int 2003;92:257-61.
    1. McConnell JD, Roehrborn CG, Bautista OM, Andriole GL Jr, Dixon CM, Kusek JW, et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med 2003;349:2387-98.
    1. Caine M, Perlberg S, Meretyk S. A placebo-controlled double-blind study of the effect of phenoxybenzamine in benign prostatic obstruction. Br J Urol 1978;50:551-4.
    1. MacDonald R, Wilt TJ, Howe RW. Doxazosin for treating lower urinary tract symptoms compatible with benign prostatic obstruction: a systematic review of efficacy and adverse effects. BJU Int 2004;94:1263-70.
    1. Lepor H. Phase III multicenter placebo-controlled study of tamsulosin in benign prostatic hyperplasia. Tamsulosin Investigator Group. Urology 1998;51:892-900.
    1. Narayan P, Tewari A. A second phase III multicenter placebo controlled study of 2 dosages of modified release tamsulosin in patients with symptoms of benign prostatic hyperplasia. United States 93-01 Study Group. J Urol 1998;160:1701-6.
    1. Wilt TJ, MacDonald R, Nelson D. Tamsulosin for treating lower urinary tract symptoms compatible with benign prostatic obstruction: a systematic review of efficacy and adverse effects. J Urol 2002;167:177-83.
    1. Chapple CR, Montorsi F, Tammela TL, Wirth M, Koldewijn E, Fernandez E. Silodosin therapy for lower urinary tract symptoms in men with suspected benign prostatic hyperplasia: results of an international, randomized, double-blind, placebo- and active-controlled clinical trial performed in Europe. Eur Urol 2011;59:342-52.
    1. Lepor H, Lepor NE, Hill LA, Trohman RG. The QT interval and selection of alpha-blockers for benign prostatic hyperplasia. Rev Urol 2008;10:85-91.
    1. Van Moorselaar RJ, Hartung R, Emberton M, Harving N, Matzkin H, Elhilali M, et al. Alfuzosin 10 mg once daily improves sexual function in men with lower urinary tract symptoms and concomitant sexual dysfunction. BJU Int 2005;95:603-8.
    1. Sakata K, Morita T. Investigation of ejaculatory disorder by silodosin in the treatment of prostatic hyperplasia. BMC Urol 2012;12:29.
    1. Chang DF, Campbell JR. Intraoperative floppy iris syndrome associated with tamsulosin. J Cataract Refract Surg 2005;31:664-73.
    1. Cantrell MA, Bream-Rouwenhorst HR, Steffensmeier A, Hemerson P, Rogers M, Stamper B. Intraoperative floppy iris syndrome associated with alpha1-adrenergic receptor antagonists. Ann Pharmacother 2008;42:558-63.
    1. Issa SA, Hadid OH, Baylis O, Dayan M. Alpha antagonists and intraoperative floppy iris syndrome: a spectrum. Clin Ophthalmol 2008;2:735-41.
    1. Chang DF, Braga-Mele R, Mamalis N, Masket S, Miller KM, Nichamin LD, et al. Clinical experience with intraoperative floppy-iris syndrome. Results of the 2008 ASCRS member survey. J Cataract Refract Surg 2008;34:1201-9.
    1. Coffey DS, Walsh PC. Clinical and experimental studies of benign prostatic hyperplasia. Urol Clin North Am 1990;17:461-75.
    1. Shapiro E. Embryologic development of the prostate. Insights into the etiology and treatment of benign prostatic hyperplasia. Urol Clin North Am 1990;17:487-93.
    1. Cabot AT. II. The question of castration for enlarged prostate. Ann Surg 1896;24:265-309.
    1. Schroeder FH, Westerhof M, Bosch RJ, Kurth KH. Benign prostatic hyperplasia treated by castration or the LH-RH analogue buserelin: a report on 6 cases. Eur Urol 1986;12:318-21.
    1. Lepor H, Williford WO, Barry MJ, Brawer MK, Dixon CM, Gormley G, et al. The efficacy of terazosin, finasteride, or both in benign prostatic hyperplasia. Veterans Affairs Cooperative Studies Benign Prostatic Hyperplasia Study Group. N Engl J Med 1996;335:533-9.
    1. Roehrborn CG, Boyle P, Nickel JC, Hoefner K, Andriole G. Efficacy and safety of a dual inhibitor of 5-alpha-reductase types 1 and 2 (dutasteride) in men with benign prostatic hyperplasia. Urology 2002;60:434-41.
    1. Fenter TC, Davis EA, Shah MB, Lin PJ. Dutasteride vs finasteride: assessment of differences in acute urinary retention rates and surgical risk outcomes in an elderly population aged ≥65 years. Am J Manag Care 2008;14(5 suppl 2):S154-9.
    1. Nickel JC, Gilling P, Tammela TL, Morrill B, Wilson TH, Rittmaster RS. Comparison of dutasteride and finasteride for treating benign prostatic hyperplasia: the Enlarged Prostate International Comparator Study (EPICS). BJU Int 2011;108:388-94.
    1. Andriole GL, Bostwick DG, Brawley OW, Gomella LG, Marberger M, Montorsi F, et al. Effect of dutasteride on the risk of prostate cancer. N Engl J Med 2010;362:1192-202.
    1. Thompson IM, Goodman PJ, Tangen CM, Lucia MS, Miller GJ, Ford LG, et al. The influence of finasteride on the development of prostate cancer. N Engl J Med 2003;349:215-24.
    1. Lucia MS, Epstein JI, Goodman PJ, Darke AK, Reuter VE, Civantos F, et al. Finasteride and high-grade prostate cancer in the Prostate Cancer Prevention Trial. J Natl Cancer Inst 2007;99:1375-83.
    1. Kirby RS, Roehrborn C, Boyle P, Bartsch G, Jardin A, Cary MM, et al. Efficacy and tolerability of doxazosin and finasteride, alone or in combination, in treatment of symptomatic benign prostatic hyperplasia: the Prospective European Doxazosin and Combination Therapy (PREDICT) trial. Urology 2003;61:119-26.
    1. Kaplan SA, McConnell JD, Roehrborn CG, Meehan AG, Lee MW, Noble WR, et al. Combination therapy with doxazosin and finasteride for benign prostatic hyperplasia in patients with lower urinary tract symptoms and a baseline total prostate volume of 25 ml or greater. J Urol 2006;175:217-20; discussion 220-1.
    1. Roehrborn CG, Siami P, Barkin J, Damiao R, Major-Walker K, Nandy I, et al. The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study. Eur Urol 2010;57:123-31.
    1. Fullhase C, Chapple C, Cornu JN, De Nunzio C, Gratzke C, Kaplan SA, et al. Systematic review of combination drug therapy for non-neurogenic male lower urinary tract symptoms. Eur Urol 2013;64:228-43.
    1. Chapple CR, Roehrborn CG. A shifted paradigm for the further understanding, evaluation, and treatment of lower urinary tract symptoms in men: focus on the bladder. Eur Urol 2006;49:651-8.
    1. Kaplan SA, Roehrborn CG, Rovner ES, Carlsson M, Bavendam T, Guan Z. Tolterodine and tamsulosin for treatment of men with lower urinary tract symptoms and overactive bladder: a randomized controlled trial. JAMA 2006;296:2319-28.
    1. Rosen RC, Giuliano F, Carson CC. Sexual dysfunction and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Eur Urol 2005;47:824-37.
    1. Vallancien G, Emberton M, Harving N, van Moorselaar RJ. Sexual dysfunction in 1274 European men suffering from lower urinary tract symptoms. J Urol 2003;169:2257-61.
    1. Andersson KE, de Groat WC, McVary KT, Lue TF, Maggi M, Roehrborn CG, et al. Tadalafil for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: pathophysiology and mechanism(s) of action. Neurourol Urodyn 2011;30:292-301.
    1. Fibbi B, Morelli A, Vignozzi L, Filippi S, Chavalmane A, De Vita G, et al. Characterization of phosphodiesterase type 5 expression and functional activity in the human male lower urinary tract. J Sex Med 2010;7(1 Pt 1):59-69.
    1. Bales GT, Christiano AP, Kirsh EJ, Gerber GS. Phytotherapeutic agents in the treatment of lower urinary tract symptoms: a demographic analysis of awareness and use at the University of Chicago. Urology 1999;54:86-9.
    1. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report 2008;12:1-23.
    1. Wilt TJ, Ishani A, Stark G, MacDonald R, Lau J, Mulrow C. Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA 1998;280:1604-9.
    1. Lapi F, Gallo E, Giocaliere E, Vietri M, Baronti R, Pieraccini P, et al. Acute liver damage due to Serenoa repens: a case report. Br J Clin Pharmacol 2010;69:558-60.
    1. Jibrin I, Erinle A, Saidi A, Aliyu ZY. Saw palmetto-induced pancreatitis. South Med J 2006;99:611-2.
    1. Bent S, Kane C, Shinohara K, Neuhaus J, Hudes ES, Goldberg H, et al. Saw palmetto for benign prostatic hyperplasia. N Engl J Med 2006;354:557-66.
    1. Barry MJ, Meleth S, Lee JY, Kreder KJ, Avins AL, Nickel JC, et al. Effect of increasing doses of saw palmetto extract on lower urinary tract symptoms: a randomized trial. JAMA 2011;306:1344-51.
    1. MacDonald R, Tacklind JW, Rutks I, Wilt TJ. Serenoa repens monotherapy for benign prostatic hyperplasia (BPH): an updated Cochrane systematic review. BJU Int 2012;109:1756-61.
    1. Strope SA, Elliott SP, Saigal CS, Smith A, Wilt TJ, Wei JT. Urologist compliance with AUA best practice guidelines for benign prostatic hyperplasia in Medicare population. Urology 2011;78:3-9.
    1. Nitti VW. Pressure flow urodynamic studies: the gold standard for diagnosing bladder outlet obstruction. Rev Urol 2005;7(suppl 6):S14-21.
    1. Porru D, Madeddu G, Campus G, Montisci I, Scarpa RM, Usai E. Evaluation of morbidity of multi-channel pressure-flow studies. Neurourol Urodyn 1999;18:647-52.
    1. Belal M, Abrams P. Noninvasive methods of diagnosing bladder outlet obstruction in men. Part 1: nonurodynamic approach. J Urol 2006;176:22-8.
    1. Lourenco T, Pickard R, Vale L, Grant A, Fraser C, MacLennan G, et al. Minimally invasive treatments for benign prostatic enlargement: systematic review of randomised controlled trials. BMJ 2008;337:a1662.
    1. Hawary A, Mukhtar K, Sinclair A, Pearce I. Transurethral resection of the prostate syndrome: almost gone but not forgotten. J Endourol 2009;23:2013-20.
    1. Reich O, Gratzke C, Bachmann A, Seitz M, Schlenker B, Mermanek P, et al. Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol 2008;180:246-9.
    1. Omar MI, Lam TB, Alexander CE, Graham J, Mamoulakis C, Imamura M, et al. Systematic review and meta-analysis of the clinical effectiveness of bipolar compared with monopolar transurethral resection of the prostate (TURP). BJU Int 2014;113:24-35.
    1. Schulman CC, Zlotta AR, Rasor JS, Hourriez L, Noel JC, Edwards SD. Transurethral needle ablation (TUNA): safety, feasibility, and tolerance of a new office procedure for treatment of benign prostatic hyperplasia. Eur Urol 1993;24:415-23.
    1. Bouza C, Lopez T, Magro A, Navalpotro L, Amate JM. Systematic review and meta-analysis of transurethral needle ablation in symptomatic benign prostatic hyperplasia. BMC Urol 2006;6:14.
    1. Jepsen JV, Bruskewitz RC. Recent developments in the surgical management of benign prostatic hyperplasia. Urology 1998;51(4A suppl):23-31.
    1. Hoffman RM, Monga M, Elliott SP, Macdonald R, Langsjoen J, Tacklind J, et al. Microwave thermotherapy for benign prostatic hyperplasia. Cochrane Database Syst Rev 2012;9:CD004135.
    1. Fabian KM. [The intra-prostatic “partial catheter” (urological spiral) (author’s transl)]. Urologe A 1980;19:236-8.
    1. Guazzoni G, Montorsi F, Coulange C, Milroy E, Pansadoro V, Rubben H, et al. A modified prostatic UroLume Wallstent for healthy patients with symptomatic benign prostatic hyperplasia: a European Multicenter Study. Urology 1994;44:364-70.
    1. Woo HH, Chin PT, McNicholas TA, Gill HS, Plante MK, Bruskewitz RC, et al. Safety and feasibility of the prostatic urethral lift: a novel, minimally invasive treatment for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). BJU Int 2011;108:82-8.
    1. National Insitute for Health and Care Excellence. Insertion of prostatic urethral lift implants to treat lower urinary tract symptoms secondary to benign prostatic hyperplasia. 2014. .
    1. Anson K, Nawrocki J, Buckley J, Fowler C, Kirby R, Lawrence W, et al. A multicenter, randomized, prospective study of endoscopic laser ablation versus transurethral resection of the prostate. Urology 1995;46:305-10.
    1. Cowles RS, 3rd, Kabalin JN, Childs S, Lepor H, Dixon C, Stein B, et al. A prospective randomized comparison of transurethral resection to visual laser ablation of the prostate for the treatment of benign prostatic hyperplasia. Urology 1995;46:155-60.
    1. Gilling PJ, Cass CB, Cresswell MD, Malcolm AR, Fraundorfer MR. The use of the holmium laser in the treatment of benign prostatic hyperplasia. J Endourol 1996;10:459-61.
    1. Mackey MJ, Chilton CP, Gilling PJ, Fraundorfer M, Cresswell MD. The results of holmium laser resection of the prostate. Br J Urol 1998;81:518-9.
    1. Malek RS, Kuntzman RS, Barrett DM. High power potassium-titanyl-phosphate laser vaporization prostatectomy. J Urol 2000;163:1730-3.
    1. Fried NM, Murray KE. High-power thulium fiber laser ablation of urinary tissues at 1.94 microm. J Endourol 2005;19:25-31.
    1. Biester K, Skipka G, Jahn R, Buchberger B, Rohde V, Lange S. Systematic review of surgical treatments for benign prostatic hyperplasia and presentation of an approach to investigate therapeutic equivalence (non-inferiority). BJU Int 2012;109:722-30.
    1. Teng J, Zhang D, Li Y, Yin L, Wang K, Cui X, et al. Photoselective vaporization with the green light laser vs transurethral resection of the prostate for treating benign prostate hyperplasia: a systematic review and meta-analysis. BJU Int 2013;111:312-23.
    1. Xia SJ, Zhuo J, Sun XW, Han BM, Shao Y, Zhang YN. Thulium laser versus standard transurethral resection of the prostate: a randomized prospective trial. Eur Urol 2008;53:382-9.
    1. Yu X, Elliott SP, Wilt TJ, McBean AM. Practice patterns in benign prostatic hyperplasia surgical therapy: the dramatic increase in minimally invasive technologies. J Urol 2008;180:241-5; discussion 245.
    1. Karsenty G, Denys P, Amarenco G, De Deze M, Game X, Haab F, et al. Botulinum toxin A (Botox) intradetrusor injections in adults with neurogenic detrusor overactivity/neurogenic overactive bladder: a systematic literature review. Eur Urol 2008;53:275-87.
    1. Patel AK, Patterson JM, Chapple CR. Botulinum toxin injections for neurogenic and idiopathic detrusor overactivity: a critical analysis of results. Eur Urol 2006;50:684-709; discussion 709-10.
    1. Chuang YC, Tu CH, Huang CC, Lin HJ, Chiang PH, Yoshimura N, et al. Intraprostatic injection of botulinum toxin type-A relieves bladder outlet obstruction in human and induces prostate apoptosis in dogs. BMC Urol 2006;6:12.
    1. Doggweiler R, Zermann DH, Ishigooka M, Schmidt RA. Botox-induced prostatic involution. Prostate 1998;37:44-50.
    1. Oeconomou A, Madersbacher H, Kiss G, Berger TJ, Melekos M, Rehder P. Is botulinum neurotoxin type A (BoNT-A) a novel therapy for lower urinary tract symptoms due to benign prostatic enlargement? A review of the literature. Eur Urol 2008;54:765-75.
    1. Maria G, Brisinda G, Civello IM, Bentivoglio AR, Sganga G, Albanese A. Relief by botulinum toxin of voiding dysfunction due to benign prostatic hyperplasia: results of a randomized, placebo-controlled study. Urology 2003;62:259-64; discussion 264-5.
    1. Marberger M, Chartier-Kastler E, Egerdie B, Lee KS, Grosse J, Bugarin D, et al. A randomized double-blind placebo-controlled phase 2 dose-ranging study of onabotulinumtoxinA in men with with benign prostatic hyperplasia. Eur Urol 2013;63:496-503.
    1. Bataller R, Brenner DA. Liver fibrosis. J Clin Invest 2005;115:209-18.
    1. Wynn TA. Integrating mechanisms of pulmonary fibrosis. J Exp Med 2011;208:1339-50.
    1. Ma J, Gharaee-Kermani M, Kunju L, Hollingsworth JM, Adler J, Arruda EM, et al. Prostatic fibrosis is associated with lower urinary tract symptoms. J Urol 2012;188:1375-81.
    1. Gharaee-Kermani M, Macoska JA. Promising molecular targets and biomarkers for male BPH and LUTS. Curr Urol Rep 2013;14:628-37.

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