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Area of Science:

  • Urology
  • Andrology
  • Pharmacology

Background:

  • Extensive advancements in treating lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) have occurred.
  • However, the optimal timing for initiating treatment for LUTS/BPH remains undetermined.

Purpose of the Study:

  • To systematically review the literature to determine if early treatment of LUTS due to BPH leads to better outcomes compared to a delayed approach.

Main Methods:

  • A systematic literature search was conducted from January 1996 to June 2016 using Medline, PubMed, and Scopus databases.
  • A Population/patient Intervention/indicator Comparator/control Outcome (PICO) framework was employed to refine the search query.
  • Articles were reviewed for relevance based on title and abstract screening.

Main Results:

  • While novel medications and surgical techniques have improved BPH treatment outcomes, evidence supporting early intervention for LUTS/BPH is weak.
  • Patients undergoing surgery after prolonged medical treatment often have larger prostates, are older, and have comorbidities.
  • Technological advancements have mitigated perioperative complications, showing a generally non-adverse trend.

Conclusions:

  • The ideal timing for initiating treatment for patients with LUTS/BPH is still uncertain.
  • There is a surprising scarcity of high-quality studies addressing this critical question.
  • Further research is needed to define criteria for identifying patients who would benefit most from early intervention.