Benign prostatic hyperplasia is the most common neoplastic condition affecting men and constitutes a major health factor impacting Americans. Although traditional approaches to treat BPH have evolved and are widely accepted medical therapy has quickly emerged a significant modality for treating patients with symptoms of BPH. Despite adrenergic antagonists, widespread use in the treatment of BPH it is curious that patients prostate size has little correlation to their symptoms and patients who are observed without undergoing suregery or medical treatment have wide fluctuations in symptoms of BPH over time and 60-70% of patients will have a favorable short term response to adrenergic therapy. This suggests that the functional component of bladder neck obstruction is being influenced by strong autonomic tone. We propose to carry out an assessment of the functional state of the autonomic nervous system in our BPH patients. We propose that autonomic hyperacitivity as measured by baseline tone and reactivity of the sympathtic nervous system is influencing the symptoms of BPH and may have a causal relationship in patients' symptomatic progression. The assessment of the sympathetic nervous system hyperactivity on BPH symptoms will be investigated by the measurement of plasma norepinephrine, heart rate, blood pressure, response to circulatory stress, 24 hour urinary catecholamines, a series of symptom scores, measurements of prostate size, post void residual, maximum urinary flow rate, measurement of abdominal fat, serum C-peptide levels, and physical activity recall forms.
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