Treatment for lower urinary tract symptoms in older men

Benign Prostatic Hyperplasia Treatment for lower urinary tract symptoms in older men s Enlargement of the prostate affects about one third of men over 50 and can cause distressing urinary symptoms. s The progress of benign prostatic hyperplasia (BPH) is unpredictable, but only a minority of men deteriorate rapidly and some will improve spontaneously. s Many men willingly tolerate mild symptoms of BPH. Care should be taken not to overtreat men who are not too bothered by their symptoms. s For the majority of men whose symptoms are not unacceptably severe, the condition may be best managed by watchful waiting and simple lifestyle changes. s The most effective treatment for severe symptoms is surgery, but about a quarter of men fail to benefit and some end up worse. s The most common operation for BPH is transurethral resection of the prostate (TURP). Incision of the prostate (TUIP) is often just as effective, uses fewer resources and is less hazardous; however it is under-used. s Drug therapy on average has a small effect on symptoms, but some men may experience significant benefit. s Because each type of treatment involves a different balance of risks and benefits, patients should be encouraged to participate in making decisions about their management.