Prostate-specific antigen (PSA) - Although BPH does not cause prostate cancer, men at risk for BPH are also at risk for this disease and should be screened accordingly (although screening for prostate cancer remains controversial)
Transurethral resection of the prostate (TURP) - The criterion standard for relieving BOO secondary to BPH
5-alpha reductase inhibitors
Electrolytes, blood urea nitrogen (BUN), and creatinine - These evaluations are useful screening tools for chronic renal insufficiency in patients who have high postvoid residual (PVR) urine volumes; however, a routine serum creatinine measurement is not indicated in the initial evaluation of men with lower urinary tract symptoms (LUTS) secondary to BPH
Urine culture - This may be useful to exclude infectious causes of irritative voiding and is usually performed if the initial urinalysis findings indicate an abnormality
Transurethral incision of the prostate (TUIP)
High-intensity ultrasonographic energy therapy - Currently in the clinical trial stage
Anticholinergic agents
Transurethral needle ablation of the prostate (TUNA)
Urinalysis - Examine the urine using dipstick methods and/or via centrifuged sediment evaluation to assess for the presence of blood, leukocytes, bacteria, protein, or glucose
Transurethral microwave therapy (TUMT) - Generates heat that causes cell death in the prostate, leading to prostatic contraction and volume reduction
Prostatic stents - Flexible devices that expand when put in place to improve the flow of urine past the prostate
Phosphodiesterase-5 enzyme inhibitors
Open prostatectomy - Reserved for patients with very large prostates (>75 g), patients with concomitant bladder stones or bladder diverticula, and patients who cannot be positioned for transurethral surgery
Alpha-adrenergic receptor blockers
Laser treatment - Used to cut or destroy prostate tissue; multiple laser types are available, including green light, holmium, and thulium, and each has its own strengths and weaknesses
