Bladder outlet obstruction: Diagnosis and medical management

Consider the possibility of bladder outlet obstruction in any man over the age of 50, but also keep an open mind with younger men. Remember, however, that not all voiding problems result from benign prostate disorders and that bladder or prostate cancer might be the underlying cause. Various questionnaires have been developed to assist in the identification of patients with symptoms of bladder outlet obstruction. The first line of treatment for mild to moderate symptoms usually consists of alpha-blocking agents because of the rapid onset of their therapeutic effect. Consider 5-alpha-reductase inhibitors, which shrink the prostate, for patients who have predominantly irritative symptoms (urgency and frequency). If medications fail to provide satisfactory symptomatic relief, then minimally invasive or even more aggressive surgical interventions may be necessary.