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Epidemiologie des benignen Prostatasyndroms

Assoziierte Risiken und Versorgungsdaten bei deutschen Männern über 50

Epidemiology of benign prostatic syndrome

Associated risks and management data in German men over age 50

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Zusammenfassung

Miktionssymptome bei benigner Prostatahyperplasie werden in Deutschland als benignes Prostatasyndrom (BPS) bezeichnet. Dies reflektiert die Variationsbreite von Symptomstärke, Prostatavolumen und Miktionsparametern. Das BPS ist eine Ausschlussdiagnose und eine progrediente Erkrankung. Das Risiko für eine Progression erhöht sich durch Alter, Symptomstärke, Prostatavolumen und Obstruktionsgrad. Prävalenzen aus einer repräsentativen Untersuchung in Deutschland (Herner BPS-Studie) lassen extrapolieren, dass unter 11.674.900 Männern über 50 Jahre 3,23 Mio. eine benigne Prostatavergrößerung („benign prostatic enlargement“, BPE; Prostatavolumen, PV >25 ml) aufweisen. Ein PV >40 ml, d. h. ein BPS mit hohem Progressionsrisiko, haben 1,5 Mio. Männer mit behandlungsbedürftigen Symptomen des unteren Harntrakts („lower urinary tract symptoms“, LUTS; IPSS >7); 2,08 Mio. zeigen eine obstruktive Blasenentleerungsstörung (definiert als Qmax <10 ml/s). 30% der Männer mit therapiebedürftigen Symptomen (IPSS >7) erhalten Medikamente, weitere 20% erhielten diese mindestens einmal, und 10% nahmen sie auch ohne signifikante Symptomatik ein. Basierend auf publizierten Progressionsparametern erleiden 18,5% deutscher Männer über 50 eine symptomatische Progression (IPSS >4), Harnverhaltung wird bei 2,4% in 5 Jahren erwartet. Die Gesamtprogression (symptomatisch, Operation oder Harnverhaltung) beträgt 27% in 5 Jahren. Dies zeigt, dass das BPS als Volkskrankheit eingestuft werden muss.

Abstract

In Germany, the condition of lower urinary tract symptoms (LUTS)/benign prostatic hypertrophy (BPH) is referred to as benign prostatic syndrome (BPS), reflecting the vast variation and interdependency of symptom severity, prostate volume, and micturition parameters. BPS is a progredient disease with distinguished risk factors for progression: age, symptom severity, prostate volume, and degree of obstruction. Therapy in Germany is provided by general practitioners and urologists. From a representative survey in Germany (the Herner BPS study), it can be calculated that among 11,674,900 men over 50 years of age, 3,230,000 have an enlarged prostate (benign prostatic enlargement, with prostate volume >25 ml). Moreover, 1,500,000 men with significant symptoms [International Prostate Symptom Score (IPSS) >7] have a prostate volume >40 ml, representing BPS with a high risk of progression, and 2,080,000 men show signs of obstruction (defined as Qmax <10 ml/s). Thirty percent of men with significant symptoms (IPSS >7) are treated medically, and an additional 20% have been prescribed medication for LUTS at least once. Ten percent of men in Germany are treated without evidence of symptoms. Based on published parameters of progression, 18.5% of men over 50 years of age will experience symptomatic progression (IPSS increase above four score points). Overall progression (symptomatic, surgery, or urinary retention) was 27% in 5 years. These findings show that BPS is a disease with substantial future effects on the German healthcare system.

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  1. Urologische Abteilung, PAN-Klinik, Zeppelinstraße 1, 50667, Köln, Deutschland

    R. Berges

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Berges, R. Epidemiologie des benignen Prostatasyndroms. Urologe 47, 141–148 (2008). https://doi.org/10.1007/s00120-008-1624-6

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