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An Approach To:

Vol. 20 No. 1 (2022)

An Approach to the Management of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia.

DOI
https://doi.org/10.26443/mjm.v19i1.330
Submitted
October 12, 2020
Published
2021-07-01

Abstract

Benign prostatic hyperplasia (BPH) is a condition that affects up to 50% of men over the age of 50; the condition’s  prevalence  increases with age, particularly after the age of 40. BPH can lead to lower urinary tract symptoms (LUTS) which can have a significant negative impact on health-related quality of life (HRQoL). Men presenting with a gradual onset of LUTS are often suspected to have BPH. However, the clinician must recognize that LUTS possess many different aetiologies. This article aims to provide medical students with a stepwise approach to the diagnosis and management of LUTS that are secondary to BPH. The outlined approach describes the differential diagnoses, required investigations, and management-related details for LUTS that are secondary to BPH. This approach is based off of relevant Canadian, American, and European urological association guidelines.

References

  1. Vuichoud C, Loughlin KR (2015) Benign prostatic hyperplasia: epidemiology, economics and evaluation. Can J Urol 22:1-6.
  2. Yeboah E (2016) Prevalence of Benign Prostatic Hyperplasia and Prostate Cancer in Africans and Africans in the Diaspora. Journal of the West African College of Surgeons 6:1.
  3. Erkoc M, Otunctemur A, Besiroglu H, et al. (2018) Evaluation of quality of life in patients undergoing surgery for benign prostatic hyperplasia. Aging Male 21:238-42.
  4. Wei JT, Calhoun E, Jacobsen SJ (2005) Urologic diseases in America project: benign prostatic hyperplasia. The Journal of urology 173:1256-61.
  5. Nickel JC, Aaron L, Barkin J, et al. (2018) Canadian Urological Association guideline on male lower urinary tract symptoms/benign prostatic hyperplasia (MLUTS/BPH): 2018 update. Can Urol Assoc J 12:303.
  6. McVary KT. Clinical manifestations and diagnostic evaluation of benign prostatic hyperplasia. Waltham, MA: UpToDate; 2020.
  7. Badalato G, Amiel G, Hollis M, et al. Medical Student Curriculum: Benign Prostatic Hypertrophy (BPH) 2020 [cited 2020 19 December]. https://www.auanet.org/education/auauniversity/for-medical-students/medical-students-curriculum/medical-student-curriculum/bph.2020 19 December, 2020.
  8. Barry MJ, Fowler FJ, O'leary MP, et al. (2017) The American Urological Association symptom index for benign prostatic hyperplasia. The Journal of urology 197:S189-S97.
  9. McVary KT, Roehrborn CG, Avins AL, et al. (2011) Update on AUA guideline on the management of benign prostatic hyperplasia. The Journal of urology 185:1793-803.
  10. Abrams P, Chapple C, Khoury S, et al. (2009) Evaluation and treatment of lower urinary tract symptoms in older men. The Journal of urology 181:1779-87.
  11. Wuerstle MC, Van Den Eeden SK, Poon KT, et al. (2011) Contribution of common medications to lower urinary tract symptoms in men. Archives of internal medicine 171:1680-2.
  12. Rendon RA, Mason RJ, Marzouk K, et al. (2017) Canadian Urological Association recommendations on prostate cancer screening and early diagnosis. Canadian Urological Association Journal 11:298.
  13. Madersbacher S, Alivizatos G, Nordling J, et al. (2004) EAU 2004 guidelines on assessment, therapy and follow-up of men with lower urinary tract symptoms suggestive of benign prostatic obstruction (BPH guidelines). European urology 46:547-54.
  14. Nguyen DD, Trinh QD, Cole AP, et al. (2021) Impact of health literacy on shared decision making for prostate‐specific antigen screening in the United States. Cancer 127:249-56.
  15. Carter HB, Albertsen PC, Barry MJ, et al. (2013) Early detection of prostate cancer: AUA Guideline. The Journal of urology 190:419-26.
  16. Alawamlh OAH, Goueli R, Lee RK (2018) Lower urinary tract symptoms, benign prostatic hyperplasia, and urinary retention. Medical Clinics 102:301-11.
  17. D’Silva KA, Dahm P, Wong CL (2014) Does this man with lower urinary tract symptoms have bladder outlet obstruction?: The Rational Clinical Examination: a systematic review. Jama 312:535-42.
  18. Foster HE, Barry MJ, Dahm P, et al. (2018) Surgical management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline. The Journal of urology 200:612-9.
  19. NICE. Quality Standard 45: Lower urinary tract symptoms in men [cited 2020 October 12]. www.nice.org.uk/guidance/QS45 October 12, 2020.
  20. Shi-Wei H, Chung-You T, Chi-Shin T, et al. (2019) Comparative efficacy and safety of new surgical treatments for benign prostatic hyperplasia: systematic review and network meta-analysis. BMJ: British Medical Journal (Online) 367.
  21. Sadri I, Arezki A, Couture F, et al. (2020) Reasons to overthrow TURP: bring on Aquablation. World journal of urology:1-9.
  22. Bouhadana D, Nguyen D-D, Schwarcz J, et al. (2021) Development of a patient decision aid for the surgical management of lower urinary tract symptoms secondary to benign prostatic hyperplasia. BJU international 127:131-5.
  23. Yu Z-J, Yan H-L, Xu F-H, et al. (2020) Efficacy and Side Effects of Drugs Commonly Used for the Treatment of Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia. Frontiers in Pharmacology 11:658.

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