Decrease in mortality from benign prostatic hyperplasia: a major unheralded health triumph.

Abstract

PURPOSE: A systematic examination of all available mortality data from benign prostatic hyperplasia (BPH) between 1950 and 1990 was done to estimate the changing international mortality pattern of this condition. MATERIALS AND METHODS: Mortality data in which BPH was the underlying cause of death were abstracted from the World Health Organization mortality data base. These data were available from a variety of international countries (in many since 1950). RESULTS: Mortality rates have decreased with considerable magnitude in developed western countries between the early 1950s and late 1980s. This fact could reasonably be attributed to the improved management of the most severe complications of BPH and to improvements in surgery and anesthesia, which have made surgical interventions of the prostate possible in a greater proportion of men, and safer in the immediate and subsequent postoperative period. CONCLUSIONS: The decreases noted in western countries, such as the United Kingdom (where 8,700 fewer men die each year presently than would be expected if the BPH mortality rates from the early 1950s still applied), United States (13,681 fewer deaths) and France (2,884 fewer deaths), indicate a considerable but unheralded achievement for modern medicine. Unfortunately, these decreases have not been observed to the same extent in central and eastern Europe and South America, where the residual high mortality rates could be lowered by education, and the widespread availability of modern surgical and anesthetic equipment.