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All about benign prostatic hyperplasia (BPH) causes of benign prostatic hyperplasia benign prostatic hyperplasia symptoms diagnosis of benign prostate hyperplasia benign prostatic hyperplasia risk factors treatment of benign prostate hyperplasia lifestyle for benign prostate hyperplasia benign prostatic hyperplasia medications BPH alternative medicines BPH surgery BPH gentle surgical treatments when to treat benign prostatic hyperplasia BPH surgery and medication

How to choose between treatment and watchful waiting for benign prostatic hyperplasia (BPH)?

The choice between watchful waiting and treatment usually depends on a number of factors, such as urine flow rates, prostate size, and PSA levels. Men with BPH who develop symptoms at around age 50 are more likely to need treatment within their lifetimes than older men. Unfortunately, there is no way at present to determine who specifically might be at risk for serious problems and need early treatment.



The evaluation of symptoms has been made somewhat easier by the development of the International Prostate Symptoms Score (IPPS). [See table above.] This scoring service serves as a benchmark for determining severity. To treat or not to treat is typically based on the guidelines described below, but the ultimate choice is often guided primarily by a man's perception of his own symptoms.

Mild or No Symptoms. Men with mild or no symptoms (IPPS scores of 7 or below) usually choose watchful waiting even if their prostates are enlarged. BPH eventually progresses to the point of needing treatment in about 15% of men with mild symptoms who wait. (It should be noted, however, that urinary tract obstructions may be present in men with enlarged prostates even if they have no symptoms, so there is some risk with this choice, although it is small.)

Moderate Symptoms. The choice is most difficult for men with moderate symptoms (scores between 8 and 19) and may simply depend on a man's ability to tolerate them. In one comparative study of such patients, after five years, only 10% of surgical patients had worse or recurrent symptoms compared to 21% of watchful waiting patients. (None of these men were taking medications, however, so it is not known how treatment with medication would compare with surgery.) Other studies have reported that up to 40% of those with moderate symptoms eventually need treatment. In a small percentage of patients, symptoms improve.

Severe Symptoms. Men with severe symptoms (scores over 20) nearly always choose treatment, although if their prostate glands are small or normal-sized, symptoms may improve.

More information on benign prostatic hyperplasia (BPH)

What is benign prostatic hyperplasia (BPH)? - Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is a noncancerous enlargement of the prostate gland that occurs in almost all men as they age.
What causes benign prostatic hyperplasia (BPH)?
- Benign prostatic hyperplasia (BPH) is probably a normal part of the aging process in men, caused by changes in hormone balance and cell-growth factors.
What are the symptoms of benign prostatic hyperplasia? - Initial symptoms of BPH include difficulty starting to urinate and a feeling of incomplete urination. Urinary tract infections cause burning or pain during urination, and possibly fever.
How does the doctor diagnose benign prostate hyperplasia? - Patients will be asked about their symptoms and may also be asked to fill out a symptom questionnaire to let the doctor know the nature of the symptoms and how troublesome they are.
Who is associated with benign prostatic hyperplasia? - Age is the major risk factor. A family history of BPH appears to increase a man's chance of developing the condition. Diabetes, in any case, worsens urinary tract symptoms in men with BPH.
How is benign prostate hyperplasia treated? - Treatment for benign prostatic hyperplasia (BPH) focuses on reducing your symptoms. Treatment is based on how severe your symptoms are, how much they bother you, and whether complications are present.
What're lifestyle measures for managing benign prostate hyperplasia? - Certain lifestyle changes can help relieve symptoms and are particularly important for men who choose to avoid surgery or drug therapy. Men with BPH should avoid, if possible, the many medications for colds and allergy that contain decongestants, such as pseudoephedrine (Sudafed).
What kinds of medicines are used for benign prostatic hyperplasia (BPH) treatment? - Alpha-blockers relax smooth muscles, especially in the urinary tract and prostate. They include terazosin (Hytrin), doxazosin (Cardura), tamsulosin (Flomax), and alfuzosin (Xatral). 5-alpha-reductate inhibitors are a group of anti-androgens. In other words, they block male hormones, particularly dihydrotestosterone.
What are alternative medicines for benign prostatic hyperplasia (BPH) treatment? - Some herbal medicines may be helpful, but no one should take any herbal medication or attempt to treat BPH without first consulting a physician.
What kind of surgery is available for benign prostatic hyperplasia (BPH) treatment? - An operation on the prostate will involve the removal of parts of the enlarged tissue. The most effective surgical procedures, transurethral resection of the prostate (TURP) and open prostatectomy, are also the most invasive.
Are there other more gentle surgical treatments for benign prostatic hyperplasia (BPH)? - Microwave thermotherapy reduces the size of the prostate by causing cells in the centre of the prostate to die. Another endoscopic treatment, in which part of the prostate tissue is removed with laser energy.
How to choose between treatment and watchful waiting for benign prostatic hyperplasia (BPH)? - The choice between watchful waiting and treatment usually depends on a number of factors, such as urine flow rates, prostate size, and PSA levels.
How to decide between surgery and medication for benign prostatic hyperplasia (BPH)? - If a man opts for treatment, there are a number of choices. Medications are the best choice for patients with mild symptoms who decide to have their condition treated. Men with moderate to severe symptoms still have good choices among drugs and surgeries.
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