Patterns of Care for Newly Diagnosed Benign Prostatic Hyperplasia in the United States

    J. Quentin Clemens, Howard B. Goldman, Kelly H. Zou, Xuemei Luo, David Russell, Douglass Chapman, Canan B. Esinduy, Jennifer T. Anger
    TLDR Most care for benign prostatic hyperplasia follows guidelines, but 5-α reductase inhibitors are often used incorrectly.
    The study analyzed diagnostic tests and treatment patterns for 38,252 men newly diagnosed with benign prostatic hyperplasia (BPH) using a national electronic health record database. Common diagnostic tests included serum creatinine (92%), serum prostate specific antigen (76%), and urinalysis (52%), with invasive testing performed in less than 20% of cases. Treatment approaches were watchful waiting (40%), pharmacological therapy (59.4%), and surgery (2.2%), with α-blockers prescribed to 50.7% of patients. Men over 65 and those with higher prostate specific antigen levels were less likely to undergo watchful waiting. The study concluded that while most clinical care aligned with guidelines, 5-α reductase inhibitor therapy was underutilized in men with large prostates and overutilized in those with small prostates.
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