Aafp bph

Benign prostatic hyperplasia BPH is a condition in which the prostate gland grows larger, aafp bph. The enlarged prostate may block or slow the passage of urine from the urethra. Doctors do not know exactly what causes BPH.

Benign prostatic hyperplasia BPH is a common condition in older men. Histologically, it is characterized by the presence of discrete nodules in the periurethral zone of the prostate gland. Chronic inability to completely empty the bladder may cause bladder distension with hypertrophy and instability of the detrusor muscle. Some patients with BPH present with hematuria. Because the severity of symptoms does not correlate with the degree of hyperplasia, and other conditions can cause similar symptoms, the clinical syndrome that often accompanies BPH has been described as lower urinary tract symptoms. The prevalence of BPH increases with age. One study suggests that the prevalence is 20 percent in year-old men and increases to 90 percent in men in their seventies.

Aafp bph

Symptomatic benign prostatic hyperplasia BPH may affect up to 30 percent of men in their early 70s, causing urinary symptoms of bladder outlet obstruction. Symptoms can improve without treatment, but the usual course is a slow progression of symptoms, with acute urinary retention occurring in 1 to 2 percent of men with BPH per year. Alpha blockers improve symptoms compared with placebo and more rapidly than with finasteride, and may be most effective in men with more severe symptoms of BPH or with hypertension. Caution : A drug safety alert has been issued on the risk of intraoperative floppy iris syndrome during cataract surgery with tamsulosin and probably with other alpha blockers. Persons taking an alpha blocker should inform their eye surgeon. Caution : A drug safety alert has been issued on the risk of male breast cancer with finasteride. Changes in breast tissue such as lumps, pain, or nipple discharge should be promptly reported for further assessment. Saw palmetto plant extracts may be no more effective than placebo at improving symptoms. However, evidence was weak, and further good-quality long-term randomized controlled trials are needed. We do not know whether rye grass pollen extract and Pygeum africanum are also beneficial, as few studies were found. Transurethral resection of the prostate TURP improves symptoms of BPH more than watchful waiting, and has been shown not to increase the risk of erectile dysfunction or incontinence. Some less invasive surgical techniques such as transurethral incision, laser ablation, transurethral holmium laser enucleation, and transurethral electrovaporization seem to be as effective as TURP at improving symptoms. TURP may be more effective at improving symptoms and preventing retreatment compared with transurethral microwave thermotherapy, but causes more complications. Transurethral microwave thermotherapy reduces symptoms compared with sham treatment or with alpha blockers, but long-term effects are unknown.

Terazosin for benign prostatic hyperplasia.

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.

Your health care provider likely will start by asking questions about your symptoms. You'll also get a physical exam. This exam is likely to include:. After that, you might need other tests that can help confirm an enlarged prostate. These tests include:. Mayo Clinic specialists have experience diagnosing complex conditions involving enlarged prostate. You have access to the latest diagnostic testing, including urodynamic and pressure flow studies.

Aafp bph

Contributor Disclosures. Please read the Disclaimer at the end of this page. Benign prostatic hyperplasia BPH is a condition that occurs when the prostate gland enlarges, potentially slowing or blocking the urine stream. Other names for benign prostatic hyperplasia include benign prostatic hypertrophy, an enlarged prostate, and BPH. In men over age 80, more than 80 percent have BPH.

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TURP may be more effective at improving symptoms and preventing retreatment compared with transurethral microwave thermotherapy, but causes more complications. PSA levels correlate with the risk of symptom progression; men with elevated PSA levels respond better to finasteride. Benign prostatic hyperplasia BPH is the most common cause of lower urinary tract symptoms in men. Transurethral enucleation of the prostate versus transvesical open prostatectomy for large benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials. Am J Mens Health. Transrectal ultrasonography is more accurate than digital rectal examination at measuring prostate size. If the symptoms bother you, there are medicines that can help you feel better. Members of the network select questions based on their relevance to family medicine. Caution : A drug safety alert has been issued on the risk of male breast cancer with finasteride. A 8 , 14 Refer patients for a surgical consultation if medical therapy fails; the patient develops refractory urinary retention, persistent hematuria, or bladder stones; or the patient chooses primary surgical therapy. Lower risk of transurethral resection syndrome hyponatremia from absorption of hypotonic irrigation into bloodstream Shorter catheterization time and length of hospital stay Fewer blood transfusions compared with TURP. In: Robbins Pathologic Basis of Disease. Alternative approaches to endoscopic ablation for benign enlargement of the prostate: systematic review of randomised controlled trials. Saw palmetto plant extracts may be no more effective than placebo at improving symptoms. Treatment costs vary widely Tables 1 and 2 26 , and the availability of less invasive surgical options also varies considerably.

Benign prostatic hyperplasia BPH is the most common cause of lower urinary tract symptoms in men.

Terazosin for benign prostatic hyperplasia. A meta-analysis on the efficacy and tolerability of alpha1-adrenoceptor antagonists in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction. Outcomes are similar to those with TURP, but the procedure takes less time to perform and causes less bleeding. Initial studies showed that AUA symptom scores decreased from 21 to 7 and maximum urinary flow rates increased from 10 to 15 mL per second in patients who underwent TUNA. 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. Eur Urol. Transurethral microwave thermotherapy reduces symptoms compared with sham treatment or with alpha blockers, but long-term effects are unknown. Lycopene: This natural pigment occurs in tomatoes. Prostate-specific antigen PSA levels should be measured in men who have at least a year life expectancy and who would be a candidate for prostate cancer treatment. However, a more recent Canadian study 29 showed increasing use of the less invasive surgical procedures. J Urol. For patients with acute urinary retention, immediately start an alpha blocker at urinary catheterization and treat the patient for three days before attempting to remove the catheter.