Benign prostatic hypertrophy: When should you consider prostatectomy for your patient?

Watching the way a patient voids is the easiest way to determine the presence of prostatic obstruction. Uroflowmetry can objectively measure the amount of obstruction. Clinical evaluation of prostatism should include an intravenous urogram, serum creatinine determination, urinalysis, urine culture, and cystoscopy. Suspicious areas of induration in the prostate should be biopsied. Surgery is not required for most men with prostatic hypertrophy. Indications for prostatectomy are severe symptoms of obstruction, significant renal or bladder decompensation, recurrent urinary tract infection, bladder calculi, and recurrent bleeding.