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When is BPE Treatment Necessary?

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Unfortunately, the progression of BPE cannot be predicted with accuracy. Symptoms and objective measurements of urethral obstruction can remain stable for many years and may even improve over time in as many as a third of men. In a large evaluation of BPE treatments, called the Medical Therapy of Prostatic Symptoms (MTOPS) study, only 14 percent of untreated men in the placebo group experienced worsening symptoms during an average follow-up time of 4.5 years.

Men who eventually need treatment for BPE typically experience a progressive decrease in the size and force of their urinary stream or a sensation of incomplete emptying of their bladder. Although frequent nighttime urination is one of the most annoying symptoms of BPE, it does not predict the need for future treatment.

If urethral obstruction worsens and is left untreated, complications can occur. Potential complications include a thickened bladder with a reduced ability to store urine, infected residual urine, bladder stones and a backup of pressure that damages the kidneys.

Treatment decisions for BPE are based on the severity of symptoms as assessed by the International Prostate Symptom Score questionnaire, the extent of urinary tract damage and the man’s age and overall health.

In general, no treatment is needed for men who have only a few symptoms and are not bothered by them. Treatment—usually surgery—is required when there is kidney damage due to inadequate bladder emptying; a complete inability to urinate after treatment of acute urinary retention; incontinence due to overfilling or increased bladder sensitivity; bladder stones; infected residual urine; recurrent blood in the urine despite treatment with medication; or symptoms that have not responded to medication and are troublesome enough to diminish quality of life.

Treatment decisions are most difficult for men who have moderate symptoms (International Prostate Symptom Score of 8 to 19). Each of these men must determine whether the symptoms bother him enough or interfere with his life enough to merit treatment. 


Posted in Enlarged Prostate on February 26, 2016

Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Health After 50 Disclaimer

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