Dr. Matt T. Rosenberg spoke at the 23rd annual Perspectives in Urology Point • Counterpoint meeting on Friday, November 14, 2014 on “What To Do in the Uncomplicated BPH Patient ”.



Keywords: BPH,  bladder, lower urinary tract symptoms (LUTS), overactive bladder (OAB), International Prostate Symptom Score (IPSS), alpha blockers (AB), Phosphodiesterase 5 Inhibitors (PDE5i), antimuscarinics

How to cite: Rosenberg, Matt T. “What To Do in the Uncomplicated BPH Patient” Grand Rounds in Urology. November 14, 2014. Accessed Jul 2020. https://grandroundsinurology.com/bph-matt-t-rosenberg-uncomplicated-patient/.


Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167-78.

Andriole G, Bruchovsky N, Chung LW, et al. Dihydrotestosterone and the prostate: the scientific rationale for 5alpha-reductase inhibitors in the treatment of benign prostatic hyperplasia. J Urol. 2004 Oct;172(4 Pt 1):1399-403.

Bechara A, Romano S, Casabé A, et al. Comparative efficacy assessment of tamsulosin vs. tamsulosin plus tadalafil in the treatment of LUTS/BPH. Pilot study. J Sex Med. 2008 Sep;5(9):2170-8.

Bosch JL, Bohnen AM, Groeneveld FP. Validity of digital rectal examination and serum prostate specific antigen in the estimation of prostate volume in community-based men aged 50 to 78 years: the Krimpen Study. Eur Urol. 2004 Dec;46(6):753-9.

Burgio KL, Newman DK, Rosenberg MT, et al. Impact of behaviour and lifestyle on bladder health. Int J Clin Pract. 2013 Jun;67(6):495-504.

Chapple CR, Roehrborn CG. A shifted paradigm for the further understanding, evaluation, and treatment of lower urinary tract symptoms in men: focus on the bladder. Eur Urol. 2006 Apr;49(4):651-8.

Crawford ED, Wilson SS, McConnell JD, et al. Baseline factors as predictors of clinical progression of benign prostatic hyperplasia in men treated with placebo. J Urol. 2006 Apr;175(4):1422-6; discussion 1426-7.

Erdem N, Chu FM. Management of overactive bladder and urge urinary incontinence in the elderly patient. Am J Med. 2006 Mar;119(3 Suppl 1):29-36.

Gacci M, Eardley I, Giuliano F, et al. Critical analysis of the relationship between sexual dysfunctions and lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol. 2011 Oct;60(4):809-25.

Gacci M, Corona G, Salvi M, et al. A systematic review and meta-analysis on the use of phosphodiesterase 5 inhibitors alone or in combination with α-blockers for lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol. 2012 May;61(5):994-1003

Giuliano F, Kaplan SA, Cabanis MJ, et al. Hemodynamic interaction study between the alpha1-blocker alfuzosin and the phosphodiesterase-5 inhibitor tadalafil in middle-aged healthy male subjects. Urology. 2006 Jun;67(6):1199-204.

Kaplan SA, McConnell JD, Roehrborn CG, et al. Combination therapy with doxazosin and finasteride for benign prostatic hyperplasia in patients with lower urinary tract symptoms and a baseline total prostate volume of 25 ml or greater. J Urol. 2006 Jan;175(1):217-20; discussion 220-1.

Kaplan SA, Gonzalez RR, Te AE. Combination of alfuzosin and sildenafil is superior to monotherapy in treating lower urinary tract symptoms and erectile dysfunction. Eur Urol. 2007 Jun;51(6):1717-23.

Lee JY, Kim HW, Lee SJ, et al. Comparison of doxazosin with or without tolterodine in men with symptomatic bladder outlet obstruction and an overactive bladder. BJU Int. 2004 Oct;94(6):817-20.

Lee RK, Chung D, Chughtai B, et al. Central obesity as measured by waist circumference is predictive of severity of lower urinary tract symptoms. BJU Int. 2012 Aug;110(4):540-5.

Lepor H. Alpha blockers for the treatment of benign prostatic hyperplasia. Rev Urol. 2007 Fall;9(4):181-90.

Liguori G, Trombetta C, De Giorgi G, et al. Efficacy and safety of combined oral therapy with tadalafil and alfuzosin: an integrated approach to the management of patients with lower urinary tract symptoms and erectile dysfunction. Preliminary report. J Sex Med. 2009 Feb;6(2):544-52.

McVary K. Lower urinary tract symptoms and sexual dysfunction: epidemiology and pathophysiology. BJU Int. 2006 Apr;97 Suppl 2:23-8; discussion 44-5.

McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011 May;185(5):1793-803.

Montorsi F, Verheyden B, Meuleman E, et al. Long-term safety and tolerability of tadalafil in the treatment of erectile dysfunction. Eur Urol. 2004 Mar;45(3):339-44; discussion 344-5.

Morlock R, Goodwin B, Gomez Rey G, et al. Clinical progression, acute urinary retention, prostate-related surgeries, and costs in patients with benign prostatic hyperplasia taking early versus delayed combination 5α-reductase inhibitor therapy and α-blocker therapy: a retrospective analysis. Clin Ther. 2013 May;35(5):624-33.

Naslund MJ, Miner M. A review of the clinical efficacy and safety of 5alpha-reductase inhibitors for the enlarged prostate. Clin Ther. 2007 Jan;29(1):17-25.

Nehra A, Jackson G, Miner M, et al. The Princeton III Consensus recommendations for the management of erectile dysfunction and cardiovascular disease. Mayo Clin Proc. 2012 Aug;87(8):766-78.

Oelke M, Bachmann A, Descazeaud A, et al. EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol. 2013 Jul;64(1):118-40.

Parsons JK. Benign Prostatic Hyperplasia and Male Lower Urinary Tract Symptoms: Epidemiology and Risk Factors. Curr Bladder Dysfunct Rep. 2010 Dec;5(4):212-218.

Porst H, Rajfer J, Casabé A, et al. Long-term safety and efficacy of tadalafil 5 mg dosed once daily in men with erectile dysfunction. J Sex Med. 2008 Sep;5(9):2160-9.

Robert G, Descazeaud A, de la Taille A. Lower urinary tract symptoms suggestive of benign prostatic hyperplasia: who are the high-risk patients and what are the best treatment options? Curr Opin Urol. 2011 Jan;21(1):42-8.

Roehrborn CG, McConnell J, Bonilla J, et al. Serum prostate specific antigen is a strong predictor of future prostate growth in men with benign prostatic hyperplasia. PROSCAR long-term efficacy and safety study. J Urol. 2000 Jan;163(1):13-20.

Roehrborn CG. Definition of at-risk patients: baseline variables. BJU Int. 2006 Apr;97 Suppl 2:7-11; discussion 21-2.

Roehrborn CG, Nuckolls JG, Wei JT, et al. The benign prostatic hyperplasia registry and patient survey: study design, methods and patient baseline characteristics. BJU Int. 2007 Oct;100(4):813-9.

Roehrborn CG, McVary KT, Elion-Mboussa A, et al. Tadalafil administered once daily for lower urinary tract symptoms secondary to benign prostatic hyperplasia: a dose finding study. J Urol. 2008 Oct;180(4):1228-34.

Roehrborn CG. Efficacy of alpha-Adrenergic Receptor Blockers in the Treatment of Male Lower Urinary Tract Symptoms. Rev Urol. 2009 Fall;11(Suppl 1):S1-8.

Roehrborn CG, Siami P, Barkin J, et al. The influence of baseline parameters on changes in international prostate symptom score with dutasteride, tamsulosin, and combination therapy among men with symptomatic benign prostatic hyperplasia and an enlarged prostate: 2-year data from the CombAT study. Eur Urol. 2009 Feb;55(2):461-71.

Rosen R, Altwein J, Boyle P, et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7).
Eur Urol. 2003 Dec;44(6):637-49.

Rosenberg MT, Staskin DR, Kaplan SA, et al. A practical guide to the evaluation and treatment of male lower urinary tract symptoms in the primary care setting. Int J Clin Pract. 2007 Sep;61(9):1535-46.

Rosenberg MT, Miner MM, Riley PA, et al. STEP: simplified treatment of the enlarged prostate. Int J Clin Pract. 2010 Mar;64(4):488-96.

Rosenberg MT, Staskin D, Riley J, et al. The evaluation and treatment of prostate-related LUTS in the primary care setting: the next STEP. Curr Urol Rep. 2013 Dec;14(6):595-605.

Shabsigh R, Kaufman J, Magee M, et al. Lack of awareness of erectile dysfunction in many men with risk factors for erectile dysfunction. BMC Urol. 2010 Nov 5;10:18.

Steers WD. Darifenacin: Pharmacology and clinical usage. Urol Clin North Am. 2006 Nov;33(4):475-82, viii.

Thompson IM Jr, Goodman PJ, Tangen CM, et al. Long-term survival of participants in the prostate cancer prevention trial. N Engl J Med. 2013 Aug 15;369(7):603-10.

Woo HH, Gillman MP, Gardiner R, et al. A practical approach to the management of lower urinary tract symptoms among men. Med J Aust. 2011 Jul 4;195(1):34-9.

Wyman JF, Burgio KL, Newman DK. Practical aspects of lifestyle modifications and behavioural interventions in the treatment of overactive bladder and urgency urinary incontinence. Int J Clin Pract. 2009 Aug;63(8):1177-91.

Yap T, Emberton M. Behaviour modification and benign prostatic hyperplasia: replacement for medications. Curr Opin Urol. 2010 Jan;20(1):20-7.