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| Search	 	 This book      All books PubMedNavigationAbout this bookAHCPR Archived Quick Reference Guide8. Benign Prostatic Hyperplasia: Diagnosis and Treatment			 Highlights of Patients Management 		Decision Diagram: Management of BPH Assessment of Treatment Outcomes Figures | Surgeon General Reports, SAMHSA TIPs, SAMHSA PEPsAHCPR Archived Quick Reference Guide8. Benign Prostatic Hyperplasia: Diagnosis and Treatment*[THIS DOCUMENT IS NO LONGER VIEWED AS GUIDANCE FOR CURRENT MEDICAL PRACTICE.]*			Benign Prostatic Hyperplasia: Diagnosis and Treatment		
Quick Reference Guide for Clinicians Number 8

AHCPR Publication No. 94-0583:

 February 1994
Purpose and Scope
 Benign prostatichyperplasia (BPH) is the most common benign neoplasm in the aging human male.The prevalence of histologically identifiable BPH increases progressively. Byage 60, prevalence is greater than 50 percent, and by age 85, approximately 90percent of men will have microscopic evidence of BPH. About half of these menwill eventually have macroscopic enlargement of the gland, and approximatelyhalf of those will progress to clinical symptoms of prostatism requiringtreatment.  

 It is estimated that one in every four men in the UnitedStates will require treatment for the relief of symptomatic BPH by age 80. Morethan 300,000 surgical procedures for BPH are currently performed annually inthe United States, most commonly transurethral resection of the prostate(TURP). 

 Like the Clinical Practice Guideline, this Quick ReferenceGuide for Clinicians applies to men over age 50 with symptoms of prostatism(for example, frequency of urination and a weak stream), but with nosignificant medical morbidities (such as diabetes) or other known causes ofvoiding dysfunction (such as urethral stricture or neurogenic bladder). The mento whom this guide applies would not be at increased risk from surgery or theother recognized treatments for BPH. At least two-thirds of the BPH patients inmost clinical settings conform to the above patient profile. 

 Ifresults of the initial evaluation of the patient (see the decision diagram,  Figure 2, page10) are not consistent with the diagnosis of BPH or reveal additionalpathologic findings, further diagnostic testing is warranted. Management ofthese patients is outside the BPH guideline and therefore not covered here. Forexample, identification of microscopic hematuria in the initial examinationclearly warrants further testing while automatically placing the patientoutside the diagnostic guideline for BPH, at least temporarily.  

 ThisQuick Reference Guide for Clinicians should preferably be used with theAmerican Urological Association (AUA) Symptom Index, a seven-itemself-administered symptom questionnaire for patients (Figure 1, page4). The AUA Symptom Index quantitatively measures the level of symptoms ofprostatism. Use of a standard symptom-scoring instrument is recommended as anintegral part of BPH patient management. 

 The BPH patient will benefitfrom reading Treating Your Enlarged Prostate: Patient Guide,which is availablefrom AHCPR. It contains information about the prostate, BPH, and the treatmentoptions available |
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