Management and Treatment of Benign Prostatic Hyperplasia Symptoms: Current Insights

Othmane Zekraoui,1 Naeem Bhojani,1,2 Kevin C Zorn,3 Dean Elterman,4 Bilal Chughtai5,6 1Faculty of Medicine, Université de Montréal, Montreal, QC, Canada; 2Division of Urology, Department of Surgery, Université de Montréal Health Center, Montreal, QC, Canada; 3BPH Canada Prostate Surgical Institute, Mont-Royal Surgical Center, Montreal, QC, Canada; 4Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada; 5Department of Urology, Northwell Health, Plainview, NY, USA; 6Department of Urology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY, USACorrespondence: Bilal Chughtai, Northwell Health, 8 Greenfield Road, Syosset, NY, 11791, USA, Email [email protected]: Benign prostatic hyperplasia (BPH) is a common cause of lower urinary tract symptoms (LUTS) in aging men that can significantly impair their quality of life. This review provides updated insights into this condition’s pathophysiology, diagnostic strategies, and the full spectrum of management approaches, including lifestyle changes, medical management, minimally invasive surgical therapies, and traditional surgical interventions. For each modality, we sought to provide an overview of the mechanism of action, efficacy, safety, as well as guideline-backed patient selection recommendations issued by three major BPH guidelines. With the various existing management strategies, the role of shared decision making is emphasized to align the therapeutic choices with symptom severity, prostate anatomy, comorbidities, but also with individual patient values. By summarizing the current and most updated literature on BPH management and treatment, our goal is to support evidence-based clinical decisions and improve care and outcomes for men suffering from BPH-related LUTS.Keywords: prostatic hyperplasia, lower urinary tract symptoms, male, quality of life