Quick Reference
Benign Prostatic Hyperplasia - Quick Reference
- Watchul waiting is sufficient, if the symptoms are mild (IPSS < 8).
- If the prostate size is < 30 ml and PSA is < 1.5 µg/l, first choice is an alpha-1 blocker: tamsulosin, alfuzosin, doxazosin or terazosin.
- If the prostate is clearly enlarged or PSA is > 1.5 µg/l, a 5-alpha-reductase inhibitor (finasteride or dutasteride) or an alpha-1 blocker can be used.
- The combination of an alpha blocker and a 5-alpha-reductase inhibitor relieves symptoms more efficiently than either drug alone.
- Phosphodiesterase 5 inhibitors are particularly suitable for patients suffering from mild to moderate urinary symptoms and who concomitantly are in need of treatment for erectile dysfunction.
Indications for referral to a urologist
- Inform the patient that he should contact the doctor if the symptoms get worse.
- Test for creatinine, PSA and (if indicated) residual urine at 6-12-month intervals.
- PSA concentration should decrease during finasteride treatment.