Aafp bph

Benign prostatic hyperplasia BPH is the most common cause of lower urinary tract symptoms in men. This article provides a review of the available patient-oriented evidence to evaluate and aafp bph lower urinary tract symptoms from BPH, aafp bph. Lower urinary tract symptoms from BPH affect

The prevalence of benign prostatic hyperplasia BPH increases with age. The physician must determine if the symptoms are secondary to BPH or other causes and provide appropriate treatment. This article provides evidence-based answers to common questions about the diagnosis and management of BPH. Onset, duration, and severity of lower urinary tract symptoms, along with additional history to rule out other causes of symptoms, should be determined. Physical examination should include a digital rectal examination and assessment for bladder distention or neurologic impairment. The initial history and physical examination focus on excluding etiologies of lower urinary tract infections other than BPH Table 1.

Aafp bph

Benign prostatic hyperplasia BPH is a condition in which the prostate gland grows larger. The enlarged prostate may block or slow the passage of urine from the urethra. Doctors do not know exactly what causes BPH. BPH usually appears after the age of 40 years. The person may notice that they urinate more often, especially at night. They may also have problems with urination, such as needing to urinate suddenly or having difficulty starting to urinate. Doctors do not know exactly what causes the condition. It is different than prostate cancer , although it may share some of the same symptoms, and it does not seem to increase the risk of this disease developing. Find out more about BPH in this article, including who is at risk and the symptoms and treatment options. The prostate is a small gland that is part of the male reproductive system. It sits under the bladder and surrounds the urethra.

Serenoa repens for benign prostatic hyperplasia. Voiding symptoms include urinary hesitancy, aafp bph, delay in initiating, intermittency, weak urinary stream, and dysuria.

Although alpha blockers and 5-alpha reductase inhibitors each reduce BPH symptoms more than placebo Strength of Recommendation [SOR]: A , alpha blockers are more effective than 5-alpha reductase inhibitors. SOR: B. Phytotherapy herbal treatment has potential but unproven benefit in BPH. In a Cochrane systematic review of 14 randomized controlled trials RCTs with 4, patients, the alpha blocker tamsulosin Flomax demonstrated dose-dependent superiority in symptom relief over placebo. There was a 12 percent improvement in the American Urologic Association AUA symptom index a point symptom score for 0. In general, a 10 to 20 percent improvement in symptom score is the minimum that is considered to be clinically significant.

Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. Benign prostatic hyperplasia, or BPH, causes your prostate gland to get bigger. The prostate gland is an organ that is usually the size of a golf ball that makes semen and surrounds the urethra. BPH is common, affecting about one-fourth of all men. BPH is more common in older men.

Aafp bph

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Early detection of prostate cancer: AUA guideline. BJU Int. The AUA recommends a serum PSA measurement in men with lower urinary tract symptoms and a life expectancy greater than 10 years. Search dates: December , January and October The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. AUA guideline on management of benign prostatic hyperplasia Cochrane reviews of rye grass pollen extract Cernilton 22 and pygeum 23 found evidence that each agent provides modest symptomatic improvement. The AUA recommends surgery if medical therapy fails or the patient develops BPH-related complications, such as bladder calculi, bladder decompensation decreased detrusor contractions , hematuria gross and microscopic , recurrent urinary tract infections, renal insufficiency, and urinary retention. The generic formulations of alpha blockers cost significantly less than their name brand counterparts, making them the most cost-effective treatment option. The goal of treatment for BPH is to reduce lower urinary tract symptoms, prevent disease progression, and prevent complications such as urinary retention. Orthostatic hypotension occurs most commonly with terazosin Hytrin and doxazosin Cardura.

Benign prostatic hyperplasia BPH is the most common cause of lower urinary tract symptoms in men. This article provides a review of the available patient-oriented evidence to evaluate and manage lower urinary tract symptoms from BPH. Lower urinary tract symptoms from BPH affect

Transurethral vaporization of the prostate TUVP or transurethral electrovaporization of the prostate TVP is now performed using endoscopic electrosurgical equipment to remove prostatic tissue with limited coagulation. Transurethral resection of the prostate is the most effective surgical procedure, although other procedures have lower risks of bleeding, incontinence, and sexual adverse effects. Betasitosterols for benign prostatic hyperplasia. A randomized trial of medical therapies for patients with moderate to severe BPH showed that the placebo group had clinical progression i. Bahnson completed postgraduate training in surgery and urology at Northwestern University Medical School, Chicago. Anticholinergic Agents. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Alternative approaches to endoscopic ablation for benign enlargement of the prostate: systematic review of randomised controlled trials. Slower and less prostatic tissue removed than with TURP Lack of large, high-quality studies with long-term outcomes. Voiding symptoms include urinary hesitancy, delay in initiating, intermittency, weak urinary stream, and dysuria. Several classes of medications may cause or exacerbate lower urinary tract symptoms, and comorbidities may contribute to these symptoms Table 2. Transurethral incision of the prostate TUIP is an endoscopic procedure using only one or two incisions to reduce constriction of the urethra without removing any of the prostate gland. The effect of finasteride on prostate specific antigen: review of available data. In men with a prostate volume greater than 40 mL, 5-alpha reductase inhibitors should be considered for the treatment of BPH.