Benign Prostatic Hyperplasia
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition
N40
DESCRIPTION
Benign prostatic hyperplasia is a noncancerous (benign) growth of the prostate gland. It usually occurs in men over 50 years of age.
May be associated with both obstructive (weak, intermittent stream and urinary hesitancy) and irritative (frequency, nocturia and urgency) voiding symptoms.
Digital rectal examination reveals a uniform enlargement of the prostate.
Urinary retention with a distended bladder may be present in the absence of severe symptoms, therefore it is important to palpate for an enlarged bladder during examination.
GENERAL MEASURES
Consult with a urologist.
Annual follow-up.
For patients presenting with urinary retention, insert a urethral catheter.
Stop medication that may aggravate urinary retention e.g. anticholinergics.
MEDICINE TREATMENT
Alpha blocker, e.g.:
- Doxazosin, oral, 4 mg daily.
- Initial dose: 1 mg daily.
- Titrate dose by 1 mg every 2 weeks to clinical effect.
- Usual maintenance dose: 4 mg daily.
LoE:Iaxxxix
Standard Treatment Guidelines and Essential Medicines List for South Africa, Adult Hospital Level, 2020-2024_Version 1.0_17 October 2024
Chapter 7 Nephrology/Urological Disorders_7.3 Urological Disorders_7.3.5 Benign Prostatic Hyperplasia