Treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia

摘要

Since pharmacotherapy was introduced in the early 1990's it has become the main line in the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). Most BPH patients can be diagnosed and treated in the primary care. Evaluation requires a history and symptom score (DAN-PSS or IPSS) and a careful physical examination including a digital rectal examination. Watchful follow-up and medical therapy are the usual first-line management options in uncomplicated BPH. Although combination therapy with both alpha-blocker and 5-alpha-reductase inhibitor is the most effective medical treatment modality also new innovations in the field of pharmacotherapy, like PDE5 inhibitors, have been introduced quite recently [1]. As a whole, it looks like we cannot expect any more very much improvement in efficacy and safety of pharmacotherapy, which means that there will be continuous need for invasive and preferably minimally invasive therapies.