Management of benign prostatic hyperplasia

Eric H. Kim, Jeffrey A. Larson, Gerald L. Andriole

Research output: Contribution to journalArticlepeer-review

39 Scopus citations

Abstract

Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS) commonly affect older men. Age-related changes associated with metabolic disturbances, changes in hormone balance, and chronic inflammation may cause BPH development. The diagnosis of BPH hinges on a thorough medical history and focused physical examination, with attention to other conditions that may be causing LUTS. Digital rectal examination and urinalysis should be performed. Other testing may be considered depending on presentation of symptoms, including prostate-specific antigen, serum creatinine, urine cytology, imaging, cystourethroscopy, post-void residual, and pressure-flow studies. Many medical and surgical treatment options exist. Surgery should be reserved for patients who either have failed medical management or have complications from BPH, such as recurrent urinary tract infections, refractory urinary retention, bladder stones, or renal insufficiency as a result of obstructive uropathy.

Original languageEnglish
Pages (from-to)137-151
Number of pages15
JournalAnnual review of medicine
Volume67
DOIs
StatePublished - Jan 14 2016

Keywords

  • 5-alpha reductase inhibitors
  • Adrenergic alpha-antagonists
  • Lower urinary tract symptoms
  • Phosphodiesterase type 5 inhibitors
  • Transurethral resection of prostate

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