Aafp bph

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

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

Because of the aging of the U. Recent studies have shown that more than 80 percent of men older than 80 years have BPH. The diagnosis of this condition is presumptive based on the patient's symptoms. These symptoms include urinary frequency, nocturia, urgency, hesitancy, weak or intermittent urine stream, straining to void, and sensation of incomplete voiding. It is common for an enlarged prostate to be found on rectal examination, but enlargement is not necessary for the diagnosis of BPH, in that palpable prostate size does not correlate with the degree of obstruction or the severity of symptoms. Although the symptoms of BPH vary from patient to patient and can be difficult to grade, they are key to the diagnosis and treatment of this condition. Instead of using traditional BPH terminology, some physicians may refer to these symptoms as lower urinary tract symptoms. To grade urinary symptoms, most physicians use the urinary symptom scoring system developed by the American Urological Association AUA. The total point score is then matched to the point range for mild, moderate, or severe BPH Figure 1. The initial evaluation should include a detailed medical history, with particular attention given to the urinary tract and comorbid conditions that may influence or complicate treatment.

The urethra is a thin tube-like structure through which semen and urine leave the body. All Rights Reserved. Alpha blockers improve symptoms compared with placebo and more rapidly than with finasteride, and may be most effective in men aafp bph more severe symptoms of BPH or with hypertension, aafp bph.

Benign prostatic hyperplasia BPH is a condition in which the prostate gland grows larger. The enlarged prostate may block or slow the passage of urine from the urethra. Doctors do not know exactly what causes BPH. BPH usually appears after the age of 40 years. The person may notice that they urinate more often, especially at night. They may also have problems with urination, such as needing to urinate suddenly or having difficulty starting to urinate.

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:.

Aafp bph

Benign prostatic hyperplasia BPH is the most common cause of lower urinary tract symptoms in men. This article provides a review of the available patient-oriented evidence to evaluate and manage lower urinary tract symptoms from BPH. Lower urinary tract symptoms from BPH affect Risk factors for BPH are listed in Table 1. Potential causes of lower urinary tract symptoms are identified with patient factors. Important family history can include urethral, bladder, prostatic, or urothelial cancer.

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Surgical removal of the inner portion of the prostate using a suprapubic or retropubic approach is the oldest and most effective treatment for relieving the symptoms of BPH and increasing maximum urinary flow. AHCPR publication no. Some people will have no symptoms and will not need treatment. Dull completed a family practice residency at Fairview Hospital, Cleveland. Saw palmetto for benign prostatic hyperplasia. Some patients who do not respond to nonselective alpha blockers may respond to tamsulosin and, because of the selectivity, may have fewer side effects, including hypotension. Although surgery tends to be more expensive than medical treatment, it is often more effective. All Rights Reserved. Although these three agents are indicated for hypertension, they are less effective than thiazide diuretics and angiotensin-converting enzyme inhibitors in preventing adverse cardiovascular outcomes, and they should not be considered first-line antihypertensive agents. This detection can enable early treatment, if necessary. However, following a healthful lifestyle from a young age, including a nutritious diet and regular exercise, may help. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. With this drug class, sexual dysfunction, although not common, is reported.

You are prohibited from using or uploading content you accessed through this website into external applications, bots, software, or websites, including those using artificial intelligence technologies and infrastructure, including deep learning, machine learning and large language models and generative AI. This AUA guideline is provided free of use to the general public for academic and research purposes. However, any person or company accessing AUA guidelines for promotional or commercial use must obtain a licensed copy.

Despite lower urinary tract symptoms from BPH affecting approximately two of every three men 50 years or older, only one-third of affected men seek treatment, and only a small number require procedural interventions. Betasitosterols for benign prostatic hyperplasia. Continue Reading. If symptoms are bothersome, however, or there is a risk of complications, a doctor may recommend treatment. The AUA 5 and the American Cancer Society 6 recommend that PSA testing and rectal examination be offered annually to men 50 years of age and older if they are expected to live at least 10 more years. Long-term complications include retrograde ejaculation 70 percent of treated patients , impotence 14 percent; range: 3 to 32 percent , partial incontinence 6 percent , and total incontinence 1 percent. Read more here. There are several types of surgery, some of which are more invasive than others. EAU guidelines on assessment, therapy and follow-up of men with lower urinary tract symptoms suggestive of benign prostatic obstruction BPH guidelines. You may have problems urinating because the prostate gland surrounds your urethra, which carries the urine out of your body see drawing. Clin Evid. Recent studies have shown that more than 80 percent of men older than 80 years have BPH. Denis LJ. Benign prostatic hyperplasia and lower urinary tract symptoms [published correction appears in N Engl J Med. Inpatient procedure Dependent on surgeon's level of expertise Higher risk of dysuria, retention, and repeat procedure compared with TURP Lack of large, high-quality studies with long-term outcomes.