Management of benign prostatic hyperplasia.
Benign prostatic hyperplasia (BPH) is a common cause of morbidity among older men. Primary care physicians need to develop expertise in its management. The causes of BPH are unknown; aging and the presence of male androgens are the dominant risk factors. Obtaining a medical history is a key step in assessing whether lower urinary tract symptoms are due to BPH or to some other process. A reliable and valid seven-item questionnaire has been developed to objectively assess symptom severity. A focused physical examination including a digital rectal exam should be performed, as well as a urinalysis and serum creatinine. Optional tests include uroflowmetry, post-void residual urine, and prostate-specific antigen measurements. BPH is treated primarily to improve the quality, rather than increase the quantity, of life. Optimal decisions about treatment are best made by a clinician and an informed patient working together.
Barry
M
M
General Medicine Division, Massachusetts General Hospital, Boston 02114, USA. BARRY@bilbo.mgh.harvard.edu
Roehrborn
C
C
D006801:Humans; D008297:Male; D010348:Patient Care Team; D010358:Patient Participation; D011468:Prostatectomy; D011470:Prostatic Hyperplasia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D014563:Urodynamics / Q000502:physiology