Benign prostatic hyperplasia (BPH) is one of the most common conditions affecting men. BPH can lead to a number of symptoms for patients commonly referred to as lower urinary tract symptoms (LUTS). Over the last decade, increased modifiable risk factors, such as metabolic disease and obesity, have resulted in an increased incidence of BPH. This increasing incidence has brought about a multitude of treatment modalities in the last two decades. With so many treatment modalities available, physicians are tasked with selecting the optimal therapy for their patients. Current therapies can first be divided into medical or surgical intervention. Medical therapy for BPH includes 5-alpha-reductase inhibitors and alpha-blockers, or a combination of both. Surgical interventions include a conventional transurethral resection of the prostate (TURP), as well as newer modalities such as bipolar TURP, holmium laser enucleation of the prostate (HoLEP), Greenlight and thulium laser, and prostatic urethral lift (PUL). Emerging therapies in this field must also be further investigated for safety and efficacy. This narrative review attempts to consolidate current and emerging treatment options for BPH and highlights the need for additional investigation on optimizing treatment selection.
Translational andrology and urology. 2019 Oct [Epub]
Soum D Lokeshwar, Benjamin T Harper, Eric Webb, Andre Jordan, Thomas A Dykes, Durwood E Neal, Martha K Terris, Zachary Klaassen
Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA., Division of Urology, Department of Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA., Division of Urology, Charlie Norwood Veteran Affairs Medical Center, Augusta, GA, USA.