ABSTRACT
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 alpha-blocker, 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.
Footnotes
↵* Milton M. Lakin, MD, has received consulting fees and honoraria from Pfizer and Eli Lilly/ICOS for consulting, teaching/speaking, and advisory board membership. He also reported having stock ownership interest in Pfizer and Eli Lilly.
↵** David R. Staskin, MD, has received honoraria from ESPRIT Pharma, Novartis, Pfizer, Ortho-McNeil, Watson Pharmaceuticals, and Astellas Pharma for teaching/speaking.
↵* Drs. Levy and Samraj reported that they have no financial relationships that pose a potential conflict of interest with this article.
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