علاج تضخم البروستاتا الحميد مع تضخم بروستاتي موثق (الحجم >30 g، PSA >1.5 ng/mL، أو الجس في الفحص الشرجي الرقمي)

DOI: 10.1097/JU.0000000000003698

• 5-ARI monotherapy should be used as a treatment option in patients with LUTS/BPH with prostatic enlargement as judged by a prostate volume of >30g on imaging, a prostate specific antigen (PSA) >1.5ng/mL, or palpable prostate enlargement on digital rectal exam (DRE).
• 5-ARI in combination with an alpha blocker should be offered as a treatment option only to patients with LUTS associated with demonstrable prostatic enlargement as judged by a prostate volume of >30g on imaging, a PSA >1.5ng/mL, or palpable prostate enlargement on DRE.
• 5-ARIs alone or in combination with alpha blockers are recommended as a treatment option to prevent progression of LUTS/BPH and/or reduce the risks of urinary retention and need for future prostate-related surgery.
• For IPSS this is a difference of >3 points.
• This, in turn, leads to a reduction in the overall androgenic growth stimulus in the prostate, an increase in apoptosis and atrophy, and ultimately a shrinkage of the organ ranging from 15–25% measured at six months.