[Benign prostatic hyperplasia. Shared care between urologists and general practitioners]

Clinical treatment of benign prostatic hyperplasia has been considered to be a task for the urologist alone. The urologist has been the only person capable of providing relief from the urethral obstruction through open and transurethral surgery. In recent years, knowledge about the physiology and pharmacology of the lower urinary tract and about the normal development of the condition has increased considerably. This has led to the development of new pharmacological drugs with positive effects on the symptoms caused by the obstructing hyperplastic prostate gland. The general practitioner now has a means of caring for patients with benign prostatic hyperplasia as long as the obstruction is not too pronounced and the symptoms are mild or moderate. Provided that urinalysis and creatinine level are normal, and there is no suspicion of malignancy, medical treatment can be considered. In cases with mild or moderate symptoms without suspicion of serious obstruction, even expectancy ("watchful waiting") may be preferred. When there is doubt about the diagnosis or when the effect of treatment is not as expected, the patient should be referred to a urologist. Benign prostatic hyperplasia is a condition where the care can suitably be shared between urologist and general practitioner.