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Prostatic Hyperplasia, Benign (BPH)

Sara M. DeSpain, MD and James E. Hougas, III, MD, FAAFP Reviewed 06/2019
 


BASICS

  • Benign prostatic hyperplasia (BPH) is due to proliferation of both the smooth muscle and epithelial cell lines of the prostate which causes increased volume and may cause compression of the ure...

DIAGNOSIS

HISTORY

  • Evaluate symptom severity with the American Urological Society Symptom Index or the International Prostate Symptom Score (IPSS).

  • Screen for other causes of symptoms such as infection, ...

TREATMENT

GENERAL MEASURES

  • Treatment ranges from watchful waiting to lifestyle modifications, medications, or surgical management.

  • Mild symptoms (score of <7) or moderate symptoms (score 8 to 15) tha...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Symptom index (IPSS) monitored every 3 to 12 months

  • DRE yearly in patients who choose watchful waiting

  • PSA yearly in patients who choose watchful ...

REFERENCES

1
McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol.  2011;185(5):1793–1803. [View Abstract on OvidMedline]
2
Pea...

ADDITIONAL READING

  • American Urological Association. American Urological Association guideline: management of benign prostatic hyperplasia (BPH). http://www.auanet.org. Accessed August 1, 2017. http://...

CODES

ICD10

  • N40.0 Enlarged prostate without lower urinary tract symptoms

  • N40.1 Enlarged prostate with lower urinary tract symptoms

ICD9

  • 600.20 Benign localized hyperplasia of prostate without urinary obst...

CLINICAL PEARLS

  • Although medical therapy has changed the management of BPH, it has only delayed the need for TURP by 10 to 15 years, not eliminated it.

  • Urinary retention, obstructive uropathy, recurren...

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