Abstract
Benign prostatic hyperplasia (BPH) and prostate cancer are two common neoplastic processes that occur in elderly men. Both of these conditions are rare before the age of 50, but by age 80 more than 80% of men have pathologic evidence of benign hyperplasia and more than 50% have at least microscopic foci of prostate cancer [1, 2]. While BPH associated urinary symptoms will impact quality of life in most elderly men, the likelihood of prostate cancer resulting in significant morbidity remains low [3, 4]. This chapter reviews the incidence of these two diseases, the appropriate evaluation of elderly men and surgical options available to the geriatric patient as well as expected outcomes.
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References
Berry SJ, Coffey DS, Walsh PC, Ewing LL (1984) The development of human benign prostatic hyperplasia with age. J Urol 132:474
Gaynor EP (1938) Zur frage des prostatakrebes. Virchows Arch Pathol Anat 301:602–652
Jacobson ST, Jacobson DJ, Girman CJ (1999) et al; Treatment for benign protstatic hyperplasia among community dwelling men: The Olmsted county study of urinary symptoms and health status. J Urol 162:1301–1306
Ketchandji M, Kuo YF, Shahinian VB et al (2009) Cause of death in older men after the diagnosis of prostate cancer. J Am Geriatr Soc 57(5):934–935. doi:10.1111/j.1532-5415.2008.02091
Caine M, Schuger L (1987) The “Capsule” in benign prostatic hypertrophy. US Department of Health and Human Services, Bethesda, p 221, NIH Publ No. 87-2881
Taylor JA 3rd, Kuchel GA (2006) Detrusor underactivity: Clinical features and pathogenesis of an underdiagnosed geriatric condition. J Am Geriatr Soc 54(12):1920–1932
Roberts RO, Bergstralh EJ, Cunningham JM et al (2004) Androgen receptor gene polymorphisms and increased risk of urologic measures of benign prostatic hyperplasia. Am J Epidemiol 159:269–276
Roberts RO, Jacobson DJ, Rhodes T et al (2004) Serum sex hormones and measures of benign prostatic hyperplasia. Prostate 61:124–131
Arrighi HM, Guess HA, Metter EJ et al (1990) Symptoms and signs of prostatism as risk factors for prostatectomy. Prostate 16:253
Elbadawi A, Yalla SV, Resnick NM (1993) Structural basis of geriatric voiding dysfunction. I. Methods of a prospective ultrastructural/urodynamic study and an overview of the findings. J Urol 150:1650–1656
Malone-Lee J, Wahedna I (1993) Characterisation of detrusor contractile function in relation to old age. Br J Urol 72:873–880
Van Mastrigt R (1992) Age dependence of urinary bladder contractility. Neurourol Urodynam 11:315
Resnick NM, Yalla SV (1987) Detrusor hyperactivity with impaired contractility: An unrecognized but common cause of incontinence in elderly patients. JAMA 257:3076–3081
Resnick NM, Yalla SV, Laurino E (1989) The pathophysiology of urinary incontinence among institutionalized elderly persons. N Engl J Med 320:1–7
Chaikin DC, Blaivas JG (2001) Voiding dysfunction: definitions. Curr Opin Urol 11:395–398
Weiss JP, Blaivas JG (2000) Nocturia. J Urol 163:5–12
Su L, Guess HA, Girman CJ et al (1996) Adverse effects of medications on urinary symptoms and flow rate: a community-based study. J Clin Epidemiol 49:483–487
McConnell JD, Barry MJ, Bruskewitz RC et al (1994) Benign prostatic hyperplasia: diagnosis and treatment. clinical practice guideline number 8. Agency for Health Care Policy & Research, Public Health Service, US Department of Health and Human Services, Rockville, MD, AHCPR Publ No. 94-0582
Mebust WK, Holtgrewe HL, Cockette ATK, Peters PC, Committee W (1989) Transurethral prostatectomy: immediate and postoperative complications: a cooperative study of 13 participating institutions evaluating 3885 patients. J Urol 141:243–247
Melchoir J, Valk WL, Foret JD, Mebust MK (1974) Transurethral prostatectomy in the azotemic patient. J Urol 112:643–646
Wasson JH, Reda DJ, Bruskewitz RC et al (1995) A comparison of transurethral surgery with watchful waiting for moderate symptoms of benign prostatic hyperplasia. N Engl J Med 332:75–79
Gacci M, Bartoletti R, Figlioli S et al (2003) Urinary symptoms, quality of life and sexual function in patients with benign prostatic hypertrophy before and after prostatectomy: A prospective study. BJU Int 91:196–200
Barry MJ, Fowler FJ Jr, O’Leary MP et al (1992) The American Urological Association’s symptom index for benign prostatic hyperplasia. J Urol 148:1549–1557, Copyright (c) 1992, Lea & Febiger
Stanford JL, Stephenson RA, Coyle LM et al (1999) Prostate cancer trends 1973–1995, SEER program. National Cancer Institute, Bethesda, NIH Pub No. 99-4543
Jemal A, Siegel R, Ward E et al (2008) Cancer statistics 2008. CA Cancer J Clin 58:71–96
Edwards CN, Steinthorsson E, Nicholson D (1953) An autopsy study of latent prostatic cancer. Cancer 32:498–506
Halpert B, Sheehan EE, Schmalhorst WR, Scott R (1963) Carcinoma of the prostate: a survey of 5000 autopsies. Cancer 16:737–742
Shimizu H, Ross RK, Bernstein L et al (1991) Cancers of the prostate and breast among Japanese and white immigrants in Los Angeles County. Br J Cancer 63:963–966
Yatani R, Chigusa I, Akazaki K et al (1982) Geographic pathology of latent prostatic carcinoma. Int J Cancer 29:611–616
Smith JR, Freije D, Carpten JD et al (1996) Major susceptibility locus for prostate cancer on chromosome 1 suggested by a genome-wide search. Science 274:1371–1374
Steinberg GS, Carter BS, Beaty TH et al (1990) Family history and the risk of prostate cancer. Prostate 17:337–340
Draisma G, Boer R, Otto SJ et al (2003) Lead times and over detection due to prostate specific antigen screening: estimates from the European Randomized Study of Screening for Prostate Cancer. J Natl Cancer Inst 95:868–878
U.S. Preventive Services Task Force (2008) Screening for prostate cancer: U.S. Preventive Services Task Force Recommendation statement. Ann Internal Med 149:185–191
Byar DP, Mostofi FK (1972) Veterans Administration Cooperative Urologic Research Groups: carcinoma of the prostate: prognostic evaluation of certain pathologic features in 208 radical prostatectomies. Cancer 30:5–13
McNeal JE (1992) Cancer volume and site of origin of adenocarcinoma of the prostate: relationship to local and distant spread. Hum Pathol 23:258–266
Gleason DF, Mellinger GT (1974) Veterans Administration Cooperative Urological Research Group: prediction of prognosis for prostatic adenocarcinoma by combined histologic grading and clinical staging. J Urol 111:58–64
Albertsen PC, Hanley JA, Fine J (2005) 20 year outcomes following conservative management of clinically localized prostate cancer. JAMA 293:2095–2101
Albertsen PC, Hanley JA, Barrows GH et al (2005) Prostate cancer and the Will Rogers Phenomenon. JNCI 97(17):1248–1253
Gilliland F, Becker TM, Smith A et al (1994) Trends in prostate cancer incidence and mortality in New Mexico are consistent with an increase in effective screening. Cancer Epidemiol Biol Prev 3:105–111
Ellis WJ, Chetner MP, Preston SD, Brawer MK (1994) Diagnosis of prostatic carcinoma: the yield of serum prostate specific antigen, digital rectal examination and transrectal ultrasonography. J Urol 52:1520–1525
Oesterling JE, Jacobsen SJ, Chute CG et al (1993) Serum prostate-specific antigen in a community-based population of healthy men: establishment of age-specific reference ranges. JAMA 270:860–864
Benson MC, Whang IS, Olsson CA et al (1992) Use of prostate specific antigen density to enhance predictive value of intermediate levels of serum prostate specific antigen. J Urol 147:817–821
Carter HB, Pearson JD, Metter JE et al (1992) Longitudinal evaluation of prostate specific antigen levels in men with and without prostate disease. JAMA 267:2215–2220
Catalona WJ, Simth DS, Wolfert RL et al (1995) Evaluation of percentage of free serum prostate-specific antigen to improve specificity of prostate cancer screening. JAMA 274:1214–1220
Albertsen PC, Hanley JA, Harlan JC et al (2000) The positive yield of imaging studies in the evaluation of men with newly diagnosed prostate cancer: a population-based analysis. J Urol 163:1138–1143
Catalona WJ, Smith DS, Ratliff TL, Basler JW (1993) Detection of organ-confined prostate cancer is increased through prostate-specific antigen-based testing. JAMA 270:948–954
Johansson JE, Homberg L, Johansson S et al (1997) Fifteen year survival in prostate cancer: a prospective, population-based study in Sweden. JAMA 277:467–471
Chodak GW, Thisted RA, Gerber GS et al (1994) Results of conservative management of clinically localized prostate cancer. N Engl J Med 330:242–248
Albertsen PC, Fryback DG, Storer BE et al (1995) Long term survival among men with conservatively treated localized prostate cancer. JAMA 274:626–631
Albertsen PC, Hanley JA, Gleason DF, Barry MJ (1998) Competing risk analysis of men aged 55 to 74 years at diagnosis managed conservatively for clinically localized prostate cancer. JAMA 280:975–980
Albertsen PC, Fryback DG, Storer BE et al (1996) The impact of co-morbidity on life expectancy among men with localized prostate cancer. J Urol 156:127–132
Lu-Yao GL, Albertsen PC, Warren J, Yao SL (1999) Effect of age and surgical approach on complications and short-term mortality after radical prostatectomy: a population-based study. Urology 54:301–307
Fowler FJ, Barry MJ, Lu-Yao G et al (1993) Patient-reported complications and follow-up treatment after radical prostatectomy. J Urol 149:622–629
Eastham JA, Kattan MW, Rogers E et al (1996) Risk factors for urinary incontinence after radical retropubic prostatectomy. J Urol 156:1707–1713
Stanford JL, Feng Z, Hamilton AS et al (2000) Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: The Prostate Cancer Outcomes Study. JAMA 283:354–360
Quinlan DM, Epstein JI, Carter BS, Walsh PC (1991) Sexual function following radical prostatectomy: influence of reservation of neurovascular bundles. J Urol 145:998–1002
Murphy GP, Mettlin C, Menck H et al (1994) National patterns of prostate cancer treatment by radical prostatectomy: results of a survey by the American College of Surgeons Committee on Cancer. J Urol 152:1817–1819
Bill-Axelson A, Holmber L, Filen F et al (2008) Radical prostatectomy versus watchful waiting in localized prostate cancer: The Scandinavian prostate cancer Group-4 randomized trial. JNCI 100:1144–1154
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Taylor, J.A., Albertsen, P.C. (2011). Benign and Malignant Diseases of the Prostate. In: Rosenthal, R., Zenilman, M., Katlic, M. (eds) Principles and Practice of Geriatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6999-6_81
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DOI: https://doi.org/10.1007/978-1-4419-6999-6_81
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