O treatment for Benign prostatic hyperplasia can be pharmacological (with medication) or surgical, in more severe cases of the disease.
After the initial evaluation with detailed anamnesis (clinical history), physical examination including digital examination of the prostate (rectal examination), urine examination and PSA, is followed by a questionnaire (IPSS - International Prostate Symptom Score) which evaluates the patient's LUTS symptoms in the last month (cited above) and provides a score ranging from 0 to 35 (asymptomatic to very symptomatic patient).
If the IPSS is less than 8, it is followed by clinical observation of the patient. If it is greater than 8, new optional diagnostic tests (flowmetry, post-voiding residue) are performed.
If the patient prefers non-invasive methods of clinical treatment or drug therapy (alpha-blockers, 5-alpha reductase inhibitors, herbal medicines or combination therapy).
If the patient prefers the invasive treatment, new optional exams are performed and a minimally invasive technique (transurethral microwave thermotherapy, transurethral needle ablation, urethral endoprostheses, or stents, balloon urethral dilatation, high-intensity focused ultrasound, laser interstitial coagulation, water-induced thermotherapy, or intra prostatic ethanol injection).
Finally, a "gold standard" surgical treatment, transurethral resection of the prostate can be performed, which leads to improvement of symptoms around 85% after one year and 75% after three years, with improvement of the urinary flow in about 95% .
In case of suspected HPB or prostate cancer, one urologist doctor should be consulted as soon as possible for correct evaluation and treatment.
