+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Benign prostatic hyperplasia (BPH) management in the primary care setting

, : Benign prostatic hyperplasia (BPH) management in the primary care setting. Canadian Journal of Urology 19 Suppl 1: 10-17

Benign prostate hyperplasia (BPH) occurs in up to 50% of men by age 50, and the incidence increases with age. This common clinical problem is diagnosed by history, including the International Prostate Symptom Score (IPSS) questionnaire, and physical examination by digital rectal examination (DRE). Initial management for BPH includes lifestyle modification, and smooth muscle relaxant alpha blocker therapy. Alpha blockers usually take effect quickly within 3-5 days, and have minimal side effects. Current commonly used alpha blockers include the selective alpha blockers tamsulosin (Flomax), alfusosin (Xatral), and silodosin (Rapaflo). For patients with larger prostates, the 5-alpha reductase inhibitor class (finasteride (Proscar) and dutasteride (Avodart)) work effectively to shrink prostate stroma resulting in improved voiding. The 5-ARI class of drugs, in addition to reducing prostate size, also reduce the need for future BPH-related surgery, and reduce the risk of future urinary retention. Drugs from the phosphodiesterase-5 (PDE-5) inhibitor class may now be considered for treating BPH. Once daily 5 mg tadalafil has been shown to improve BPH-related symptoms and is currently approved to treat patients with BPH. Referral to a urologist can be considered for patients with a rising prostate-specific antigen (PSA), especially while on 5-ARI, failure of urinary symptom control despite maximal medical therapy, suspicion of prostate cancer, hematuria, recurrent urinary infections, urinary retention, or renal failure. Currently the primary care physician is armed with multiple treatment options to effectively treat men with symptomatic BPH.


PMID: 23089343

Other references

Hach, B., 1976: Neurophychiatric clinical picture in vitamin B 12 deficiency. Die Medizinische Welt 27(50): 2433-2434

Zhu, W.; Chen, Y.; Tang, Q.; Liao, L.; Li, D., 2017: Treatment of patellofemoral instability in adolescent by anatomical double-bundle medial patellofemoral ligament reconstruction with double suture anchor technique. 目的:探讨双缝合锚钉技术双束解剖重建内侧髌股韧带治疗青少年髌股关节不稳定的临床疗效。方法:2013年1月至2014年12月对25例青少年髌股关节不稳定患者行双缝合锚钉技术双束解剖重建...

Plowman, P., 1993: This is Babylon, Part 2. Midwifery Today and Childbirth Education: 26, 42-23, 45

Muth, T.R.; Dunbar, L.A.; Cortois-Coutry, N.; Roush, D.L.; Caplan, M.J., 1997: Sorting and trafficking of ion transport proteins in polarized epithelial cells. Transport proteins are targeted to specific plasmalemmal domains in polarized epithelial cells. The molecular signals that govern these sorting events are just beginning to be elucidated. In many cases, the cell surface delivery of transport prote...

Shen, T.; Wong, C.F.; McCammon, J.A., 2001: Atomistic Brownian dynamics simulation of peptide phosphorylation. We report the implementation of an all-atom Brownian dynamics simulation model of peptides using the constraint algorithm LINCS. The algorithm has been added as a part of UHBD. It uses adaptive time steps to achieve a balance between computational...

Koch, G.V., 1876: A note on the structure of Halisarca dujardini, by G. V. KOCH, Morph. JB. ii. pp. 83 84.. A note on the structure of Halisarca dujardini, by G. V. KOCH, Morph. JB. ii. pp. 83 & 84.

Brotherton, H.O.; Yost, R.A., 1984: Rapid screening and confirmation for drugs and metabolites in racing animals by tandem mass spectrometry. A screening and confirmation procedure for drugs and metabolites in the blood serum and urine of racing animals (horses and greyhounds) was developed. Equine blood serum was spiked with low concentrations of several drugs of interest. Canine blood...

Kaczmarek, A., 1939: Investigations on the dying-out of grafted Vines in new plantations of the Saale and Unstrut region. This is a full account of investigations started in 1928 to ascertain the causes of the high mortality of grafted vines in newly planted vineyards in the Saale and Unstrut region of Germany, which aroused considerable apprehension among the local...

Long J.P.; Althausen A.F., 1988: The use of abdominal ct scanning in the diagnosis of parastomal hernias. Journal of Urology 139(4 PART 2): 396A

Markov A.M.N., 1957: Influence of qualitatively different fats in nutrition on fat assimilation and nitrogen retention in an organism. In experiments on rats, assimilation of synthetic fat, combined fat, lard, and sunflower oil related to their influence on N retention in animal organisms was studied. Rats received a synthetic ration for 2 to 3 months, 30% of whose caloric value...