Benign prostatic hyperplasia. Early recognition and management

At the present time the medical management of prostatic hyperplasia remains primarily in the investigative stage. Various prostatic inhibitory substances, primarily hormonal in nature, have been studied in animals and humans. The work of Scott with cyproterone acetate in a group of 13 patients with nodular hyperplasia demonstrated improvement of the obstructive symptoms in 11 patients, an increased flow rate in 9, reduction of residual urine in 8, decrease in prostatic size in 7, and epithelial histologic changes in 8. Nevertheless in spite of these and other encouraging preliminry results, the principal therapy for genign prostatic hyperplasia is surgical relief of bladder neck obstruction by prostatectomy which has a mortality rate of less than one per cent. The effects of medical therapy remain uncertain and are employed primarily in patients who are poor surgical risks.