A rational approach to benign prostatic hyperplasia evaluation: recent advances.
OBJECTIVE
In this article we aim to outline the recent advances in the evaluation of a patient with symptoms suggestive of benign prostatic hyperplasia. We define the role of the clinical evaluation and techniques that are evolving for the appropriate management of a patient with benign prostatic hyperplasia. Both non-invasive and invasive investigation techniques are reviewed.


RESULTS
Initiating early and appropriate treatment is the primary aim of investigation for a patient with lower urinary tract symptoms. Both clinical history and examination and appropriate investigations are vital to establishing a diagnosis. Symptom scores, prostate specific antigen and prostate volume were found to closely relate in predicting the progression of benign prostatic hyperplasia and in recent years increased interest has centred on the progression of this disease principally related to the development of new pharmacotherapy. Despite these positive findings further research is needed to develop reliable tools to predict progression. Newer ultrasound techniques hold promise for the future. Conventional pressure flow studies have a defined role in excluding patients who are less likely to benefit from prostatic surgery by providing information on detrusor function; and non-invasive urodynamic techniques need further evaluation but appear to be promising.


CONCLUSIONS
The minimal initial evaluation of a patient with benign prostatic hyperplasia should include a thorough history, digital rectal and neurological examinations, symptom scoring (including quality of life and sexual score) and measurement of serum prostate specific antigen. Other methods should be reserved for more complex situations. Attempts should be made at identifying those patients in whom the disease process is likely to progress.
Bhargava
Saurabh
S
Department of Urology, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.
Canda
A Erdem
AE
Chapple
Christopher R
CR
D000368:Aged; D001707:Biopsy, Needle; D003952:Diagnostic Imaging / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination / Q000379:methods; D017430:Prostate-Specific Antigen / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000175:diagnosis*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014563:Urodynamics
D017430:Prostate-Specific Antigen