Benign prostatic hyperplasia: When to 'watch and wait,' when and how to treat
Albert Levy, MD
Assistant Clinical Professor of Medicine, Mount Sinai School of Medicine, New York, NY
George P. Samraj, MD
Associate Professor, Family Medicine, Department of Community Health and Family Medicine, University of Florida, Gainesville, FL
Correspondence: Albert Levy, MD, Manhattan Family Practice, 911 Park Avenue, New York, NY 10021; email@example.com
Drs. Levy and Samraj reported that they have no financial relationships that pose a potential conflict of interest with this article.
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 alphablocker, 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.