Doctors Issue New Guidelines on Spotting, Treating
FRIDAY, Feb. 4 (HealthDay News) -- Experts at the American
Urological Association (AUA) have issued updated guidelines on
diagnosing and treating enlarged prostate -- a common condition
formally know as benign prostatic hyperplasia (BPH).
BPH can lead to lower urinary tract symptoms such as
incontinence and affect a man's quality of life. The new
guidelines, the first since 2003, include a detailed procedure on
how to help doctors diagnose and treat those urinary tract
problems. They also lower the age at which doctors should start to
look for these issues in patients --- the "index patient age" --
from 50 to 45.
"This document provides much-needed guidance to doctors who are already treating lower urinary tract symptoms, as well as those who will be in the future," Dr. Kevin T. McVary, chair of the guidelines panel, said in an AUA news release.
When treating a patient with suspected lower urinary tract
issues, a doctor should obtain a relevant medical history, assess
symptoms using the AUA's symptom index, and conduct a full physical
examination, including a digital rectal exam, the new guidelines
Laboratory tests should include a prostate-specific antigen
(PSA) blood test and a urine analysis. Urine frequency and volume
charts may also prove useful in reaching a diagnosis.
The advisory also includes new recommendations about drug
treatment for enlarged prostate and advises doctors to delay
prescribing alpha-blocker drugs to treat an enlarged prostate if a
patient is scheduled for eye cataract surgery.
Patients already taking alpha blockers should inform their eye
doctor prior to cataract surgery. That's because cataract surgery
patients taking alpha blockers are at risk for a complication
called intraoperative floppy iris syndrome, which can lead to
increased pain, a longer recovery and less improvement in
One urologist called the new guidelines "a welcomed update."
"Since the last published guideline in 2003, many new medical and surgical therapies have emerged to help urologists treat men who suffer from lower urinary tract symptoms related to BPH. Incorporating these new treatments in the new 2011 guideline will help to standardize care for all men diagnosed with BPH," said Dr. David Shin, assistant professor of urology at the medical school of the University of Medicine and Dentistry of New Jersey, and a clinician at Hackensack University Medical Center.
"Interestingly, the 2011 guideline also lowered the index patient age to 45 from 50," he added. "It is not surprising that younger men are having lower urinary tract symptoms since enlargement of the prostate begins at age 45. With this new AUA guideline, physicians will be able to effectively treat both the younger and older male suffering from voiding dysfunction related to their enlarged prostate."
The guideline is expected to be published in an upcoming issue
The Journal of Urology.
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