Strategy in the management of benign prostatic hyperplasia.

More than half of the patients over 50 years of age consulting formictional symptoms have a benign prostatic hyperplasia. For 30%of them, benign prostatic hyperplasia is not the main or uniquecause of these symptoms. The development of therapeutic means,whether medical, physical or surgical, should, in theory, bring preciseanswers. At present, it is not the case, due to several reasons.First of all, it is never easy to establish, except in the presence of anacute or a chronic evident obstruction possibly accompanied bycomplications, an exact role to each of the modifications on the lowurinary tract frequently met at this age, even on the central nervoussystem for the older patients. Therefore the establishment of atherapeutic protocol often passes through stages, from the leastinvasive medical treatment to the most invasive classic surgery, andpossibly through alternatives using physical means (US, microwaves,laser, etc.). In conclusion, management strategy of benignprostatic hyperplasia can be considered only with the patient’s informedconsent.