Peer Reviewed
Feature Article Men’s health
Assessing and managing benign prostatic hyperplasia
Abstract
The prevalence of benign prostatic hyperplasia is increasing, and, although rarely life threatening, this condition can have a significant impact on a patient’s quality of life and morbidity.
Key Points
- The aetiology of benign prostatic hypertrophy (BPH) is not yet known, but heredity, increasing age and the presence of testosterone appear to play a part.
- Most patients with BPH present with a mixture of lower urinary tract symptoms.
- The most useful initial investigation for patients with BPH is an ultrasound of the urinary tract, with determination of postvoid residual bladder volume.
- Observation is appropriate for patients with mild to moderate symptoms but no complications related to the BPH.
- Patients with mild to moderate symptoms that significantly impact on their quality of life are candidates for medical therapy, usually with an alpha blocker or finasteride.
- Surgical treatment is reserved for patients with more severe symptoms or who fail initial medical therapy; transurethral resection of the prostate is considered the gold standard of treatment of symptomatic BPH.
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