Uroselective agents

Drugs that can worsen BPH
*** Exam cases will include these 4

AUA snxs index for BPH
1. AUA < 8 (i.e. 0 - 7) = Mild LUTS
2. AUA =/> 8 = LUTS score >/= 8 w/o bordersome snxs
3. AUA =/> 8 = LUTS score >/= 8 w bordersome snxs
4. AUA 20 - 35

DRE minimum
PSA minimum

Trt Algorithm for BPH management
Mild Snxs
(AUA 0 - 7)

Trt Algorithm for BPH management
Mod snx + ED
(AUA 8 - 19)

Trt Algorithm for BPH management
Mod snx + small prostate and low PSA
(AUA 8 - 19)

Trt Algorithm for BPH management
Mod snx + large prostate and high PSA
AUA 8 - 19

Trt Algorithm for BPH management
Mod snx + irritative voiding snxs
AUA 8 - 19

Trt Algorithm for BPH management
Severe Snxs = Complications of BPH
AUA = 20 - 35
DRE = > 40 g
PSA = > 1.5 ng/dL

α1-adrenergic antagonists drugs
("Zosins")

5α-Reductase Inhibitors

Combination 5α-Reductase Inhibitor/α-Adrenergic Receptor
Antagonist

phosphodiesterase inhibitors (PDE-5 inhibitors)

Antimuscarinic agents

What do you give a patients with an enlarged prostate of greater than 40 grams and/or a PSA elevated to > 1.5 ng/mL?

TURP

Open prostatectomy

TUIP

TUNA

TUMT

Lifestyle Modification / Behavioral changes for BPH pts. (1)

Lifestyle Modification / Behavioral changes for BPH pts. (2)

Lifestyle Modification / Behavioral changes for BPH pts. (3) ***

Lifestyle Modification / Behavioral changes for BPH pts. (4)

What is the trt option in men with VEGF and hematuria due to prostatic bleeding

3rd Gen 5α-Reductase Inhibitors
Selective α1 Inhibitors