121 Benign Prostate Hyperplasia GUIDELINES ON BENIGN PROSTATIC HYPERPLASIA (Text update March 2005) M. Oelke (chairman), G. Alivizatos, M. Emberton, S. Gravas, S. Madersbacher, M. Michel, J. Nordling, C. Rioja Sanz, J. de la Rosette Background Benign prostatic hyperplasia (BPH) is one of the most com- mon benign diseases in men that can lead to benign prostatic enlargement (BPE), benign prostatic obstruction (BPO) and/ or lower urinary tract symptoms (LUTS). Bothersome LUTS occur in about 30% of men older than 65 years. The aetiology is multi-factorial with age, PSA and prostate volume being the true factors related to the development of the disease. A group of patients at increased risk of progres- sion, and for whom it might be appropriate to initiate early treatment, can be identified based on these specific risk factors. The need for surgery to treat BPH increases with age and with the degree of clinical symptoms at baseline. Nocturia and changes of urinary flow stream seem to be the most predictive symptoms. Assessment of men with BPH These recommendations apply only to men above 50 years of age without significant risk of non-BPH related origin of LUTS. Men with concomitant neurological diseases, younger