EAU guidelines on benign prostatic hyperplasia (BPH)

Objective:To establish guidelines for the diagnosis, treatment, and follow- up of BPH. Methods:A search of published work was conducted using Medline. In combinat ion with expert opinions, recommendations were made on the usefulness of te sts for assessment and follow-up: mandatory, recommended, or optional. In a ddition, indications and outcomes for the different therapeutic options, we re: reviewed. Results:A digital rectal examination is mandatory in the assessment for the diagnosis of BPH:. Recommended tests are the International Prostate Sympto m Score, creatinine measurement (or renal, ultrasound), uroflowmetry, and p ostvoid residual urine volume. All other tests are optional. The aim of tre atment is to improve patients' quality of life, and it depends on the sever ity of the symptoms of BPH. The watchful waiting policy is recommended for patients with mild symptoms, medical treatment for patients with mild-moder ate symptoms, and surgery for patients who failed medication or conservativ e management and who have moderate-severe symptoms, and/or complications of BPH which require surgery. Regarding non-surgical treatments, transurethra l microwave thermotherapy is the most attractive option. These treatments s hould be reserved for patients who prefer to avoid surgery or who no longer respond favourably to medication. Finally, recommendations for follow-up t ests and a recommended follow-up time schedule. after BPH treatment are pro vided. Conclusions: Recommendations for assessment, possible therapeutic options, and follow-up. of patients with BPH are made.. Copyright (C) 2001 S. Karger AG, Basel.