Emberton et al reported an algorithm for the medical management of benign prostatic hyperplasia (BPH). this was derived from a model reported by Marberger. The authors are from multiple institutions in Europe.
Patient selection: male with benign prostatic hyperplasia
Parameters:
(1) International Prostate Symptom Score (IPSS), from 0 to 35
(2) level of bother experienced by patient
(3) enlarged prostate based on prostate volume in mL or serum PSA in ng/mL
Criteria for an enlarged prostate:
(1) prostate volume >= 30 mL
(2) if prostate volume not available, then serum PSA >= 1.5 ng/mL
IPSS
Bother
Enlarged Prostate
Medical Management
<= 7
NA
NA
watchful waiting
> 7
none or little
NA
watchful waiting
> 7
moderate or severe
no
alpha-adrenergic blocker
> 7
moderate or severe
yes
5alpha-reductase inhibitor; alpha adrenergic blocker; or combination
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