Benign Prostatic Hyperplasia is a progressive disease characterized with lower urinary tract symptoms (LUTS) such as difficult urination, frequency and nocturia. Acute urinary retention and the need for BPH surgery are major risk factors for progression. Several studies have been conducted to examine these factors. IPSS scoring system developed by American Urological Association (AUA) is an important test used for the subjective evaluation of BPH and LUTS. In general, progression is defined as worsening of symptoms, decrease in flow rate, increase in prostate volume (PV) and development of acute urinary retention (AUR). Early diagnosis and treatment of high - risk patients are important. By the use of 5 - alpha reductase inhibitor, prostate volume is decreased and accordingly improvements are observed in the symptoms, thus reduction in the risk of AUR and the need for surgery can be obtained. Surgical operations after AUR is known to increase morbidity and mortality. PSA is also shown as a strong predictor for the risk of AUR. “BPH nomogram” is promising to determine the risk of progression. Although IPSS, Qmax and PVR values are associated with progression, further studies are needed to determine progression and surgical risk more clearly. By determining the risk of progression, quality of life worsening due to BPH can be prevented and serious conditions effecting patient's life such as AUR and surgical treatment can be predicted and avoided.

Keywords: prostate, BPH, urinary retention, surgery