Hammad Ather.
Benign prostatic obstruction (BPO) – Treatment.
Med Today Nov ;1(3):73-7.

Benign prostatic obstruction (BPO) is often a progressive disorder with a potential for complications if remains untreated. On the hand, when no treatment is offered, a significant number of patients with mild disease often show no signs of deterioration. This uncertainty in the clinical course of this disease is manifested in the treatment options. Consequently, treatment for BPO varies from watchful waiting to open prostatectomy. Watchful waiting is a valid treatment option for a selected group of patients with mild symptoms with minimal impact on quality of life and good compliance. Recent advances in medical treatment have made this the first line treatment for majority of patients, who do not have absolute indication for operative treatment. Finasteride and Dutasteride are offered to patients in whom intervention is indicated with an enlarged prostate (> 40 gm). Alpha- adrenergic antagonists, however, could be given to patients with bothersome lower urinary tract symptoms irrespective of prostate size. Interventional treatment is at present reserved for patients with failed medical treatment, or for complicated BPO. Among the operative treatments Transurethral resection of the prostate (TURP) is the gold standard. Other options which have stood the test of time include Holmium laser prostatectomy and Trans urethral microwave thermo therapy (TUMT). Use of high intensity focused ultrasound (HIFU) and transurethral needle ablation (TUNA) have very limited indications and is for use in specialized centres. This is a review article.

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