Barry M, Roehrborn C
General Medicine Division, Massachusetts General Hospital, Boston 02114, USA.
Annu Rev Med. 1997;48:177-89. doi: 10.1146/annurev.med.48.1.177.
Benign prostatic hyperplasia (BPH) is a common cause of morbidity among older men. Primary care physicians need to develop expertise in its management. The causes of BPH are unknown; aging and the presence of male androgens are the dominant risk factors. Obtaining a medical history is a key step in assessing whether lower urinary tract symptoms are due to BPH or to some other process. A reliable and valid seven-item questionnaire has been developed to objectively assess symptom severity. A focused physical examination including a digital rectal exam should be performed, as well as a urinalysis and serum creatinine. Optional tests include uroflowmetry, post-void residual urine, and prostate-specific antigen measurements. BPH is treated primarily to improve the quality, rather than increase the quantity, of life. Optimal decisions about treatment are best made by a clinician and an informed patient working together.
良性前列腺增生（BPH）是老年男性发病的常见原因。基层医疗医生需要培养其管理方面的专业技能。BPH的病因尚不清楚；衰老以及男性雄激素的存在是主要危险因素。获取病史是评估下尿路症状是由BPH还是其他某种疾病引起的关键步骤。已开发出一种可靠且有效的七项问卷来客观评估症状严重程度。应进行包括直肠指检在内的重点体格检查，以及尿液分析和血清肌酐检测。可选检查包括尿流率测定、排尿后残余尿量测定和前列腺特异性抗原检测。治疗BPH主要是为了提高生活质量，而非延长寿命。关于治疗的最佳决策最好由临床医生和了解情况的患者共同做出。
