Recently,
evidence-based recommendations were made concerning
the diagnosis and treatment of benign prostatic hyperplasia
(BPH) at the 5th International Consultation on BPH.
These recommendations suggest using diagnostic tools
that are evidence-based for a specific condition, in
this instance a male patient with lower urinary tract
symptoms (LUTS).
These
tools include:
A
clinical history incorporating the Symptom Index for BPH
(see Appendix B), and a
physical examination that includes a digital rectal examination
(DRE)
Laboratory
testing, including a prostate specific antigen (PSA) and
a urinalysis
Additional
diagnostic tools exist for evaluating and monitoring these
symptoms. Some of these tools, while not incorporated into
evidence-based recommendations, still provide unique information
to the clinician who is developing a treatment strategy. These
include:
Flow
rates
Measurement
of post-void residual bladder volume (PVR)
Cystoscopy
Urodynamics
Although
the serum creatinine (recently dropped from the evidence-based
recommendations) may also be useful in numerous instances,
like many other useful tools it has not been considered evidence-based
because studies of adequate power have yet to be conducted.
