Benign prostatic hyperplasia: when to 'watch and wait,' when and how to treat.
Benign prostatic hyperplasia (BPH) is a clinical diagnosis. While BPH is a common cause of lower urinary tract symptoms (LUTS) in men, LUTS can signify a number of other disease states. For this reason, the patient evaluation, which includes a digital rectal examination, and careful differential diagnosis are crucial in men with LUTS. Many men with BPH are asymptomatic, and many others are not bothered by their symptoms; watchful waiting is appropriate management for these patients. When symptoms affect quality of life, pharmacologic therapy should be an option; choices include an alphablocker, a 5 alpha-reductase inhibitor, or, for men with larger prostates, a combination of the two. Surgical intervention is indicated when BPH leads to other medical complications, including urinary retention and renal insufficiency.
Levy
Albert
A
Mount Sinai School of Medicine, New York, NY, USA. alevymd@earthlink.net
Samraj
George P
GP
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D001378:Azasteroids / Q000627:therapeutic use; D003937:Diagnosis, Differential; D018450:Disease Progression; D000068538:Dutasteride; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D018120:Finasteride / Q000627:therapeutic use; D006801:Humans; D008297:Male; D019370:Observation; D011470:Prostatic Hyperplasia / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D013997:Time Factors
D000317:Adrenergic alpha-Antagonists; D001378:Azasteroids; D004791:Enzyme Inhibitors; D018120:Finasteride; D000068538:Dutasteride