THE MEDICAL-MANAGEMENT OF LOWER URINARY-TRACT SYMPTOMS AND BENIGN PROSTATIC HYPERPLASIA

Prostatism is a widely used term assigned to the symptom complex of ol der men with voiding dysfunction. The cause of the syndrome has routin ely been ascribed to an enlarged prostate. More recent thinking recogn izes that many men with such symptoms do not, in fact, have prostate e nlargement or benign prostatic hyperplasia (BPH) and that such symptom s are not a surrogate for BPH. Such recognition is essential if cost e ffective medical management of lower urinary tract symptoms (LUTS) is to be achieved. Prostate volume has emerged as a key factor in the sel ection of medical therapy of LUTS and BPH not only regarding symptom r elief but also to the newer concept of the prevention of disease progr ession and the avoidance of future adverse events in those men with tr ue BPH. In the United States, medical management is now first line the rapy for LUTS. The proper selection of therapy based on the patient's individual pathophysiologic characteristics is now made possible by ma ny new recent studies within the medical literature.