UPDATE - Issue 18 - Summer 2004
New guideline for management of BPH
The British Association of Urological Surgeons recently launched guidelines for GPs to help in the diagnosis, management and monitoring of Benign Prostatic Hyperplasia (BPH) patients. Benign enlargement of the prostate is one of the most prevalent conditions affecting men beyond middle age. One in seven men between 40 and 49 and one in two in the 60 to 69 group has the condition. Key management objectives are to provide lasting symptom relief and to reduce the risk of disease progression towards acute urinary retention or BPH related surgery. Over the past decade the prevalence of prostatic surgery has decreased whilst medical therapy has become increasingly popular. There are two lines of medical attack on the problems posed by benign enlargement. The class of drugs known as 5 alpha-reductase inhibitors work to shrink the prostate by inhibiting the enzyme that causes growth of prostate cells, whilst alpha blockers work by relaxing the smooth muscle tissue at the bladder neck, thus reducing outflow obstruction.
The guidelines recommend the use of 5 alpha-reductase inhibitors in men who are judged to be at risk of progression whilst alpha blockers are recommended for men at lower risk or in combination with a 5 alpha-reductase inhibitor if the symptoms are particularly bothersome.