Highlights & Basics
- Benign prostatic hyperplasia (BPH) presents with both storage symptoms (frequency, urgency, nocturia, and incontinence) and voiding symptoms (weak stream, dribbling, dysuria, straining).
- Physical examination may demonstrate prostate size/volume ≥30 g, nodules or tenderness suspicious of prostate cancer or prostatitis.
- Evaluation includes history and examination including an abdominal exam for a palpable bladder, a digital rectal exam, and a neurologic assessment.
- Urinalysis, prostate-specific antigen (PSA) level, and International Prostate Symptom Score are first-line tests of powerful diagnostic impact in the appropriate patient groups. Given the debate regarding the morbidity and mortality reduction of prostate cancer with PSA testing, discuss the implications with the patient before testing.
- Use shared decision-making based on understanding the patient's desires and risks associated with specific therapies to guide treatment strategies.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Citations
Sandhu JS, Bixler BR, Dahm P, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH): AUA guideline amendment 2023. J Urol. 2024 Jan;211(1):11-9.[Abstract][Full Text]
European Association of Urology. Management of non-neurogenic male LUTS. 2024 [internet publication].[Full Text]
Elterman D, Aubé-Peterkin M, Evans H, et al. Update - Canadian Urological Association guideline: male lower urinary tract symptoms/benign prostatic hyperplasia. Can Urol Assoc J. 2022 Aug;16(8):245-56.[Abstract][Full Text]
Expert Panel on Urological Imaging; Alexander LF, Oto A, Allen BC, et al. ACR Appropriateness Criteria® lower urinary tract symptoms - suspicion of benign prostatic hyperplasia. J Am Coll Radiol. 2019 Nov;16(11s):S378-83.[Abstract][Full Text]
McConnell JD, Roehrborn CG, Bautista O, et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med. 2003 Dec 18;349(25):2387-98.[Abstract]
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