Canadian guidelines for the management of benign prostatic hyperplasia.
OBJECTIVE
To develop the first Canadian guidelines for the management of lower urinary tract symptoms in men with benign prostatic hyperplasia (BPH).


METHODS
These guidelines, developed under a mandate provided by the Canadian Urological Association (CUA), were a collaborative effort between the CUA guidelines committee and the Canadian Prostate Health Council. BPH guidelines developed by the American Urological Association, the European Association of Urology, the World Health Organization International Consultation on BPH, and similar committees from Germany, Sweden and Australia were reviewed. The committee further reviewed a systematic literature search, updated to May 2004, and systematically derived Canadian urological opinion data.


RESULTS
The subsequent Canadian BPH guidelines were developed as an evidence based consensus among the committee members. Mandatory evaluation includes history, physical examination and urinalysis, while a symptom inventory and PSA in selected patients are recommended. Serum creatinine, uroflow, voiding diary, post void residual and sexual function questionnaire are optional. Unless there is an indication, other related tests are not recommended. Treatment choices should be governed by the severity of the symptoms, bother and patient preference. Guidelines for medical, surgical and minimally invasive treatment as well as special considerations are described in terms of guideline, option and recommendation.


CONCLUSIONS
Diagnostic and treatment guidelines for BPH reflect the Canadian social priorities, economics, socialized medical practice, manpower issues, and medicolegal considerations.
Nickel
J Curtis
JC
Department of Urology, Queen's University, Kingston General Hospital, Ontario, Canada.
Herschorn
Sender
S
Corcos
Jacques
J
Donnelly
Bryan
B
Drover
Doug
D
Elhilali
Mostafa
M
Goldenberg
Larry
L
Grantmyre
John
J
Laroche
Bruno
B
Norman
Richard
R
Piercy
Bruce
B
Psooy
Karen
K
Steinhoff
Gary
G
Trachtenberg
John
J
Saad
Fred
F
Tanguay
Simon
S
D002170:Canada; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D010347:Patient Care Planning; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011470:Prostatic Hyperplasia / Q000175:diagnosis / Q000628:therapy*
D017430:Prostate-Specific Antigen