Diagnosis and management of benign prostatic hyperplasia.

摘要: Benign prostatic hyperplasia is a common condition affecting older men. Typical presenting symptoms include urinary hesitancy, weak stream, nocturia, incontinence, and recurrent tract infections. Acute retention, which requires urgent bladder catheterization, relatively uncommon. Irreversible renal damage rare. The initial evaluation should assess the frequency severity of impact on patient's quality life. American Urological Association Symptom Index validated instrument for objective assessment symptom severity. also digital rectal examination urinalysis. Men with hematuria be evaluated cancer. A palpable nodule or induration prostate referral to rule out For men mild symptoms, watchful waiting annual reassessment appropriate. Over past decade, numerous medical surgical interventions have been shown effective in relieving benign hyperplasia. Alpha blockers improve quickly. Although 5-alpha reductase inhibitors slower onset action, they may decrease size alter disease course. Limited evidence shows that herbal agents saw palmetto extract, rye grass pollen pygeum relieve symptoms. Transurethral resection often provides permanent relief. Newer laser-based techniques comparable effectiveness transurethral up two years after surgery lower perioperative morbidity. Various outpatient are associated reduced morbidity, but relief less durable.