LINTHICUM, MD, February 3, 2011—The American Urological Association (AUA) released today a new clinical Guideline on the Treatment of Benign Prostatic Hyperplasia (BPH), which updates current guidance on diagnosing and treating this common condition in men, which can lead to lower urinary tract symptoms (LUTS) and impact the quality of life for patients. The AUA released its own original guidance on BPH first in 2003. A full Executive Summary of the Guideline is expected to be published in an upcoming issue of The Journal of Urology. A Webinar about the guideline will soon be available online at www.AUAnet.org.
The update to the guideline, finalized in late 2010, includes a detailed diagnostic algorithm to guide a physician in diagnosing and treating LUTS secondary to BPH, as well as in-depth information on its basic management and the management of complicated cases. Physicians treating men with suspected cases of LUTS should obtain a relevant medical history, assess symptoms using the AUA Symptom Index and conduct a full physical examination (including a digital rectal exam). Laboratory tests should include a prostate-specific antigen (PSA) test and a urinalysis to exclude infection or other causes for LUTS. Frequency and volume charts may also be useful in providing a diagnosis.
The 2003 update provided key information on the use of pharmacologic therapies to treat BPH (in addition to surgical therapies available); the 2010 edition contains added recommendations for the use of anti-cholinergic drugs and the use of laser therapies. Additionally, the index patient age has been lowered to 45 from 50, to better guide physicians in treating younger men who may be experiencing lower urinary symptoms.
The Guideline also includes cautionary statements about intraoperative floppy iris syndrome (IFIS) in cataract patients taking alpha-blockers to treat BPH. The AUA cautions physicians to question patients about any planned cataract surgery prior to their starting an alpha-blocker regimen (men planning cataract surgery should avoiding initiating alpha blockers until after their surgery has been completed). Those men already taking the drugs should inform their ophthalmologists of their alpha-blocker regimen prior to surgery.
“The increasing life expectancy and growth of our elderly population will increase the number of men who suffer from LUTS. This will place increased demands for treatment services, and necessitate the incorporation of evidence-based medicine in that treatment,” said Kevin T. McVary, M.D., chair of the panel that developed the Guideline. “This document provides much-needed guidance to doctors who are already treating LUTS, as well as those who will be in the future.”
The prostate is a walnut-sized gland that surrounds the male urethra. An enlarged prostate can lead to lower urinary tract symptoms, or LUTS, that can grow progressively worse as the gland grows. LUTS can be caused by direct bladder outlet obstruction (BOO) or by increased smooth muscle tone and resistance within the prostate, and can directly and significantly affect a man’s quality of life. In fact, for many men, the severity and degree of bother of LUTS symptoms are the most important motivators for them to seek treatment.
For more information on this Guideline or to schedule an interview with Dr. McVary, please contact Wendy Isett at 410-689-3932 or communications@AUAnet.org.
About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is the pre-eminent professional organization for urologists, with more than 16,000 members throughout the world. An educational nonprofit organization, the AUA pursues its mission of fostering the highest standards of urologic care by carrying out a wide variety of programs for members and their patients.
Wendy Isett, AUA