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Benign Prostatic Hyperplasia (BPH)

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Urologic Principles and Practice

Part of the book series: Springer Specialist Surgery Series ((SPECIALIST))

Abstract

Benign prostatic enlargement (BPE) is one of the most common diagnosis in older men and is due to a histopathological condition called “benign prostatic hyperplasia” (BPH) which usually develops after the fourth decade of life. Clinical manifestations of BPH include symptoms, signs and sequelae of urinary obstruction (BOO) caused by BPE. Although not life-threatening, its clinical manifestations as lower urinary tract symptoms (LUTS) affect between 15% and 30% of men aged over 60 years and patients seek treatment to improve their quality of life. Recommended tests, to be performed in all patients with bothersome LUTS and BPE included: medical history, quantification of symptoms and bother, physical examination, urinalysis, serum prostate antigen (PSA), frequency volume chart, uroflowmetry with post-voiding residual volume and ultrasound imaging of the prostate Optional tests were considered: upper urinary tract imaging, pressure-flow studies and endoscopy of the lower urinary tract. Alpha-blockers, 5 alpha reductase inhibitors, antimuscarinics, phosphodiesterase type 5 (PDE5) inhibitors and beta 3-agonist are considered the pillars of LUTS management while the role of plant extracts is still under investigation. When pharmacological treatment fails or in patients with BPH complications, surgical treatment is recommended. Surgical techniques mainly include minimally invasive techniques, transurethral resection of prostate, laser surgery and open prostatectomy.

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Authors and Affiliations

  1. Department of Urology, Ospedale Sant’Andrea, University “La Sapienza”, Rome, Italy

    Cosimo De Nunzio, Riccardo Lombardo, Antonio Maria Cicione & Andrea Tubaro

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  1. Cosimo De Nunzio
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  2. Riccardo Lombardo
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  3. Antonio Maria Cicione
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  4. Andrea Tubaro
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Editors and Affiliations

  1. Sheffield Teaching Hospitals NHS Foundation, Sheffield, UK

    Christopher R. Chapple

  2. Department of Urology, University of Virginia, Charlottesville, VA, USA

    William D. Steers

  3. Department of Urologic Surgery, University of California, Davis, Sacramento, CA, USA

    Christopher P. Evans

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De Nunzio, C., Lombardo, R., Cicione, A.M., Tubaro, A. (2020). Benign Prostatic Hyperplasia (BPH). In: Chapple, C., Steers, W., Evans, C. (eds) Urologic Principles and Practice. Springer Specialist Surgery Series. Springer, Cham. https://doi.org/10.1007/978-3-030-28599-9_20

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  • DOI: https://doi.org/10.1007/978-3-030-28599-9_20

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