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KMID : 0614720070500070626
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Journal of Korean Medical Association
2007 Volume.50 No. 7 p.626 ~ p.636
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Benign Prostatic Hyperplasia
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Kim Choung-Soo
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Abstract
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Benign prostatic hyperplasia (BPH), a pathological terminology that means benign proliferation of prostatic tissue, is commonly used as a clinical terminology indicating low urinary tract symptoms (LUTS) resulting from prostate enlargement. It mainly arises from the transition zone of the prostate by stimulation of dihydrotestosterone (DHT), and its incidence is about 21~28% in men with age over fifty. LUTS related to BPH consist of frequency, residual urine sense, nocturia, interruption, urgency, weak stream, and hesitancy. The International Prostate Symptom Score (IPSS) is currently being used for the evaluation of the patient in the clinical setting. The size of the prostate (>30 g), an elevated serum prostate-specific antigen level (PSA: >1.5ng/mL), high IPSS ( 20), and a large amount of post-void residual urine (>100ml) are considered as risk factors of BPH aggravation. Physical examination including digital rectal examination, urinalysis, serum PSA, and uroflowmetry with residual urine measurement are performed as basic test items for BPH. Standard initial treatment of BPH is medical therapy: mainly alpha adrenergic blockers and 5-alpha reductase inhibitors, and optionally anticholinergics, desmopressin, and phytotherapy. The standard surgical treatment of BPH nowadays is transurethral resection of prostate (TURP) but open prostatectomy or minimally invasive treatment such as transurethral incision of prostate (TUI), thermal therapy, and photoselective vaporization of prostate (PVP) can be applied in selected cases.
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KEYWORD
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Benign prostatic hyperplasia, Low urinary tract symptoms, Alpha-adrenergic blockers, Transurethral resection of prostate
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