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Benign Prostatic Hyperplasia (BPH)

Also known as: BPH · prostate enlargement · lower urinary tract symptoms

Age-related non-cancerous prostate enlargement causing lower urinary tract symptoms — hesitancy, a weak stream, incomplete emptying, frequency and nocturia. Complications include acute retention and infection.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

Older men (prevalence rises with age).

Red flags — escalate / refer

Acute urinary retention (painful, unable to void), haematuria, renal impairment from chronic retention, or features suggesting prostate cancer (a hard nodule, very high PSA) → urgent care/urology.

Work-up / diagnosis

1Symptom assessment (e.g., IPSS) and examination including a digital rectal exam.
2Urinalysis, renal function and PSA (after counselling); a bladder scan/flow studies where needed; exclude other causes and prostate cancer.

Management — overview

Mild symptoms → watchful waiting and lifestyle measures (fluid timing, reduce caffeine/alcohol).
Medical therapy — an alpha-blocker for rapid symptom relief, and a 5-alpha-reductase inhibitor to shrink a large prostate over months (often combined).
Manage acute retention with catheterisation (then an alpha-blocker before a trial without catheter); surgery (e.g., TURP) for refractory symptoms or complications.

In-depthFull dosing & advanced protocol

Drug dosing

Alpha-blocker

Rapid symptom relief

Adult dose: Per protocol
Route: Oral

Caution: Postural hypotension; caution before cataract surgery (floppy-iris).

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

5-alpha-reductase inhibitor (± combination)

Large prostate; reduce retention/surgery risk

Adult dose: Per protocol (effect over months)
Route: Oral

WHOWHO Model List of Essential Medicines (electronic EML) (2025 (24th)) ↗

Alpha-blockers fast; 5-ARIs shrink over months

Alpha-blockers relieve symptoms quickly; 5-ARIs take months but shrink the gland and reduce retention/surgery.
Always exclude prostate cancer and retention.
Anticholinergic drugs can precipitate retention.

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Alpha-blocker

5-alpha-reductase inhibitor (± combination)

📈 Alpha-blockers fast; 5-ARIs shrink over months

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Alpha-blocker

5-alpha-reductase inhibitor (± combination)

📈 Alpha-blockers fast; 5-ARIs shrink over months

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Alpha-blockers fast; 5-ARIs shrink over months

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Alpha-blockers fast; 5-ARIs shrink over months

References