TY  - EJOU
AU  - Barkin, Jack 

TI  - Management of benign prostatic hyperplasia by  the primary care physician in the 21<sup>st</sup> century:  the new paradigm
T2  - Canadian Journal of Urology

PY  - 2008
VL  - 15
IS  - Suppl.4
SN  - 1488-5581

AB  - Benign prostatic hyperplasia (BPH) is one of the commonest 
causes of lower urinary tract symptoms (LUTS) in men 
over age 50. Fifty percent of men over age 50 will require 
some type of management for BPH/LUTS symptoms. 
Until about 15 years ago, the most common management 
for BPH was a transurethral resection of the prostate 
(TURP) operation. Initially, once a diagnosis of BPH has 
been made, most men are treated medically. One must 
fi rst rule out other serious causes of these symptoms, such 
as prostate cancer, bladder cancer, and other obstructions. 
For men with an enlarged prostate, there is a good chance 
that therapy with a 5-alpha-reductase inhibitor (5-ARI) 
can prevent disease progression and the need for surgery. 
There has been a lot of recent work on different combination 
therapies for the treatment of BPH/LUTS. If a patient’s 
serum prostate-specifi c antigen (PSA) level is greater than 
1.5 ng/ml and his prostate volume is greater than 30 cc and 
he has signifi cant LUTS, then combination medical therapy 
of an alpha blocker with a 5-ARI is the most effective 
therapy. After a careful workup, it is quite reasonable and 
appropriate for the primary care physician to initiate this 
therapy for a patient with BPH/LUTS.
KW  - BPH
KW  -  LUTS
KW  -  PSA
KW  -  combination medical  therapy
KW  -  5-ARI
KW  -  alpha blocker
KW  -  prostate cancer

DO  -