Opinion
Video
BPH: The Patient Journey
Author(s):
A panelist discusses how benign prostatic hyperplasia (BPH) management involves a comprehensive patient journey that encompasses initial diagnostic evaluation, tailored pharmacological interventions including α-blockers and 5-α reductase inhibitors, and a progressive treatment approach ranging from conservative drug therapy to potential surgical options based on symptom severity and patient response.
Video content above is prompted by the following:
Condition Overview
BPH is a common age-related condition characterized by noncancerous enlargement of the prostate gland, which can significantly impact lower urinary tract symptoms and patient quality of life.
Patient Journey
Initial Presentation
- Typical patient profile: Aging male (typically 50+ years)
- Primary symptoms include:
- Urinary frequency
- Nocturia
- Weak urinary stream
- Difficulty initiating urination
- Incomplete bladder emptying
Diagnostic Approach
- Comprehensive clinical assessment
- Digital rectal examination
- Prostate-specific antigen testing
- Urinary flow rate measurements
- Potential imaging studies (ultrasound, urodynamic studies)
Treatment Modalities
Pharmacological Interventions
- α-Blockers
- Mechanism: Relaxes prostate and bladder neck muscles
- Examples: tamsulosin, alfuzosin
- Rapid symptom relief
- Minimal impact on prostate size
- 5-α Reductase Inhibitors
- Mechanism: Reduces prostate size by blocking testosterone conversion
- Examples: finasteride, dutasteride
- Slower onset of action
- Beneficial for long-term prostate volume reduction
- Combination Therapy
- Combining α-blockers and 5-α reductase inhibitors
- Provides comprehensive symptom management
- Recommended for patients with larger prostates
- Phosphodiesterase-5 Inhibitors
- Example: Tadalafil
- Dual benefit of treating BPH symptoms and erectile dysfunction
- Lower dosage for BPH management
