Watchful waiting in benign prostatic hyperplasia
- 1 January 2009
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Urology
- Vol. 19 (1), 3-6
- https://doi.org/10.1097/mou.0b013e32831a6ec6
Abstract
Watchful waiting is a well known approach to the management of benign prostatic hyperplasia (BPH). In recent years, several large longitudinal studies have published their findings on the natural history of BPH. In addition, several other studies reporting the outcomes of patients randomized to medical treatment versus placebo have been used to extrapolate patients who are at low risk for progression. Both longitudinal studies and randomized placebo-controlled trials have confirmed the progressive nature of BPH, with symptom progression being the most common manifestation. Variables such as baseline prostate-specific antigen, prostate volume, symptom score and bother score, decreased flow rate, and increased postvoid residual have all been linked to progression to acute urinary retention and need for surgery. Historically, not much has been known about the natural history of BPH and thus, who would be a good candidate for watchful waiting. In this review, we discuss the natural history of BPH and the outcomes of affected patients managed with watchful waiting, as well as variables predictive of progression.Keywords
This publication has 8 references indexed in Scilit:
- PSA velocity in conservatively managed BPH: Can it predict the need for BPH-related invasive therapy?The Prostate, 2006
- Longitudinal study of men with mild symptoms of bladder outlet obstruction treated with watchful waiting for four yearsUrology, 2004
- The Long-Term Effect of Doxazosin, Finasteride, and Combination Therapy on the Clinical Progression of Benign Prostatic HyperplasiaNew England Journal of Medicine, 2003
- TREATMENT FOR BENIGN PROSTATIC HYPERPLASIA AMONG COMMUNITY DWELLING MEN: THE OLMSTED COUNTY STUDY OF URINARY SYMPTOMS AND HEALTH STATUSJournal of Urology, 1999
- 5-YEAR OUTCOME OF SURGICAL RESECTION AND WATCHFUL WAITING FOR MEN WITH MODERATELY SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA: A DEPARTMENT OF VETERANS AFFAIRS COOPERATIVE STUDYJournal of Urology, 1998
- A Comparison of Transurethral Surgery with Watchful Waiting for Moderate Symptoms of Benign Prostatic HyperplasiaNew England Journal of Medicine, 1995
- Natural history of benign prostatichyperplasia and risk of prostatectomy: The Baltimore Longitudinal Study of AgingUrology, 1991
- Transurethral Prostatectomy: Immediate and Postoperative Complications. A Cooperative Study of 13 Participating Institutions Evaluating 3,885 PatientsJournal of Urology, 1989