The term BPH is misused

Drug companies market drugs for BPH (benign prostatic hyperplasia). However, this is a misuse of the term, which all dictionaries define as a histological term and not related to gross anatomical change. It is therefore disappointing that the BMJ has commissioned review articles on BPH .1 Several important organisations have accepted the arguments presented in the BMJ in 1994, that the term LUTS (lower urinary tract symptoms) should be used rather than “prostatism,” and now “storage” and “voiding” symptoms are the preferred terms to “irritative” and “obstructive” symptoms.2 3 4 5 However, these organisations also supported the proposal for the proper use of the terms BPH (histology), BPE (enlargement), and BPO (obstruction).5

Using the correct terminology (BPH, BPE, BPO) is likely to protect men from inappropriate treatment and help ensure that care is focused on the cause of their LUTS.

All men have prostates, and if they live long enough they will get histological BPH: more than 50% of men aged 50 and 80% of men older than 70. However, only a quarter of those with BPH will get BPO. The gradual development of either BPH or BPE, without obstruction, seems highly unlikely to cause bothersome LUTS. Wilt and N’Dow mention the causes of LUTS other than prostatic obstruction, but the emphasis is on the prostate.1 Unless clinicians appreciate the increasing prevalence of overactive bladder and nocturnal polyuria, men are unlikely to get the help they need when they present with symptoms that affect their quality of life.