OBJECTIVE: To discuss the classifications of patients with lower urinary tract symptoms ascribed to BPH, in order to define the indication for treatment for patients with similar features but of a different etiology. The literature is also reviewed. METHODS/ RESULTS: Two patients, aged 62 and 63 years, diagnosed as having BPH were found to have a gastrointestinal stromal tumor (GIST) and a leiomyosarcoma of the prostate, respectively. The first patient had undergone retropubic resection. Frozen section analysis revealed a GIST. The second patient had undergone TURP twice. A perineal biopsy at the last medical examination showed a leiomyosarcoma of the prostate. This patient finally underwent pelvic tumorectomy. The international classification of BPH is discussed: PQSF (P: prostatic weight determined by transrectal US or DRE; Q: quality of life assessment; S: international prostate symptom score (IPSS); F: maximum urinary flow rate by uroflowmetry--Qmax). CONCLUSIONS: The classifications are practical, but should be improved. In our view, details useful in orienting the diagnosis could be lost by oversimplification.
OBJECTIVE: To discuss the classifications of patients with lower urinary tract symptoms ascribed to BPH, in order to define the indication for treatment for patients with similar features but of a different etiology. The literature is also reviewed. METHODS/ RESULTS: Two patients, aged 62 and 63 years, diagnosed as having BPH were found to have a gastrointestinal stromal tumor (GIST) and a leiomyosarcoma of the prostate, respectively. The first patient had undergone retropubic resection. Frozen section analysis revealed a GIST. The second patient had undergone TURP twice. A perineal biopsy at the last medical examination showed a leiomyosarcoma of the prostate. This patient finally underwent pelvic tumorectomy. The international classification of BPH is discussed: PQSF (P: prostatic weight determined by transrectal US or DRE; Q: quality of life assessment; S: international prostate symptom score (IPSS); F: maximum urinary flow rate by uroflowmetry--Qmax). CONCLUSIONS: The classifications are practical, but should be improved. In our view, details useful in orienting the diagnosis could be lost by oversimplification.