Authors' objectives:

This report aims to summarise the research evidence for the treatment of benign prostatic hyperplasia (BPH), or lower urinary tract symptoms in older men.

Authors' recommendations: Enlargement of the prostate affects about one third of men over 50 and can cause distressing urinary symptoms. The progress of benign prostatic hyperplasia (BPH) is unpredictable, but only a minority of men deteriorate rapidly and some will improve spontaneously. Many men willingly tolerate mild symptoms of BPH. Care should be taken not to overtreat men who are not too bothered by their symptoms. For the majority of men whose symptoms are not unacceptably severe, the condition may be best managed by watchful waiting and simple lifestyle changes. The most effective treatment for severe symptoms is surgery, but about a quarter of men fail to benefit and some end up worse. The most common operation for BPH is transurethral resection of the prostate (TURP). Incision of the prostate (TUIP) is often just as effective, uses fewer resources and is less hazardous; however it is under-used. Drug therapy on average has a small effect on symptoms, but some men may experience significant benefit. Because each type of treatment involves a different balance of risks and benefits, patients should be encouraged to participate in making decisions about their management.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.york.ac.uk/inst/crd/ehcb.htm

Year Published: 1995

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: University of York

Contact Address: University of York, York, Y01 5DD, United Kingdom. Tel: +44 1904 321040, Fax: +44 1904 321041,

Contact Name: crd@york.ac.uk

Contact Email: crd@york.ac.uk

Copyright: Centre for Reviews and Dissemination