STAGING AND GRADING OF PATIENTS WITH LOWER URINARY TRACT SYMPTOMS (LUTS): A PATHOPHYSIOLOGICAL CLASSIFICATION FOR FURTHER MANAGEMENT
Authors:
K. T. Foo
Authors‘ workplace:
Department of Urology, Singapore General Hospital, National University of Singapore
Published in:
Urol List 2009; 7(3): 36-38
Overview
BPH is a heterogeneous disease. Using non invasive transabdominal ultrasound, it can be graded according to the prostate volume (PV) and configuration: Intravesical prostatic protrusion (IPP) to predict obstruction. The severity of the disease can be staged according to the presence or absence of significant obstruction and bothersome symptoms. Stage one would be patient with no significant obstruction and no bothersome symptoms, and stage II would be patients with bothersome symptoms but no significant obstruction. Stage III patients are those with significant obstruction, irrespective of symptoms. Stage IV would be patients with complications of BPH. Low grade, low stage patients can generally be watched, high grade high stage patients would need more invasive treatment such as surgical removal of the adenoma.
Stage II patients with low grade IPP can be managed with alpha blockers, while those with high grade IPP and large prostate > 40 grams would benefit from 5 alpha reductase inhibitors. This pathophysiological classification with grade (pathology) and stage (physiology), using non invasive parameters, can be used to compare results of treatment across institutions and also would improve the cost effective management of this common disease BPH.
Key words:
benign prostatic hyperplasia, grading and staging
Sources
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Paediatric urologist UrologyArticle was published in
Urological Journal
2009 Issue 3
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