Benign Prostatic Hyperplasia
(BPH; Benign Prostatic Hypertrophy; Prostatism; Bladder Outlet Obstruction)
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- Difficulty starting to urinate
- Weak urination stream
- Dribbling at end of urination
- Sensation of incomplete bladder emptying
- Urge to urinate frequently, especially at night
- Deep discomfort in lower abdomen
- Urge incontinence —strong, sudden urge to urinate
- Urine flow study
- Cystometrogram (a functional study of the way your bladder fills and empties)
- Post-void residual volume test—measures whether you can empty your bladder completely
- 5 alpha-reductase inhibitors—to shrink the prostate, which may decrease some urination problems.
- Alpha-blockers—relax the muscles around the neck of the bladder and the prostate to improve urine flow.
- Antimuscarinics—to relax the bladder muscles, which helps to reduce the urge to urinate frequently.
- Phosphodiesterase-5 enzyme inhibitor — erectile dysfunction medication that can also improve the symptoms of BPH.
Minimally Invasive Interventions
- Transurethral microwave thermotherapy (TUMT)—uses microwaves to destroy excess prostate tissue
- Transurethral needle ablation (TUNA)—uses low levels of radio frequency energy to burn away portions of the prostate
- Transurethral laser therapy—uses highly focused laser energy to remove prostate tissue
- Transurethral surgical resection of the prostate (TURP) —a scope is inserted through the penis to remove the enlarged portion of the prostate
- Open surgery—removal of the enlarged portion of the prostate through an incision, usually in the lower abdominal area, much more invasive then TURP or TUIP
- Transurethral incision of the prostate (TUIP)—small cuts are made in the neck of the bladder to widen the urethra
Prostatic stents—tiny metal coils that are inserted into urethra to widen it and keep it open
- Usually used for men who do not wish to take medication or have surgery
- Does not appear to be a good long-term option
National Kidney and Urologic Diseases Clearinghouse http://kidney.niddk.nih.gov
Prostate Cancer Research Institute http://prostate-cancer.org
Canadian Urological Association http://www.cua.org
The Prostate Centre at The Princess Margaret http://www.prostatecentre.ca
Beta-sitosterol. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary. Updated August 2011. Accessed October 7, 2011.
Fagelman E, Lowe FC. Saw palmetto berry as a treatment for BPH. Rev Urol. 2001 Summer;3(3):134-8.
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Greco KA, McVary KT. The role of combination medical therapy in benign prostatic hyperplasia. Int J Impot Res. 2008 Dec;20 Suppl 3:S33-43.
Marberger M. Drug insight: 5-alpha-reductase inhibitors for the treatment of benign prostatic hyperplasia. Nat Clin Pract Urol. 2006 Sep;3(9):495-503.
Prostate enlargement: Benign prostatic hyperplasia. National Kidney Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement. Updated March 23, 2012. Accessed August 22, 2013.
Roehrborn CG, Siami P, Barkin J, et al; CombAT Study Group. The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study. Eur Urol. 2010;57(1):123-131.
Ulbricht C, Basch E, Bent S, et al. Evidence-based systematic review of saw palmetto by the Natural Standard Research Collaboration. J Soc Integr Oncol. 2006;4(4):170-86.
Update on the UAU guideline on the management of benign prostatic hyperplasia. J Urol. 2011 May; 185(5):1793-803.
10/7/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Barry MJ, Meleth S, Lee JY, et al. Effect of increasing doses of saw palmetto extract on lower urinary tract symptoms: a randomized trial. JAMA. 2011;306(12):1344-1351.
10/14/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: US Food and Drug Administration. FDA approves Cialis to treat benign prostatic hyperplasia. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm274642.htm. Updated October 6, 2011. Accessed October 14, 2011.
5/27/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Gacci M, Corona G, et al. Metabolic syndrome and benign prostatic enlargement: A systematic review and meta-analysis. BJU Int. 2014 Mar. [Epub ahead of print].
- Reviewer: Adrienne Carmack, MD
- Review Date: 09/2013 -
- Update Date: 00/52/2014 -