Portal de Periódicos da CAPES

Criterios de derivación en hiperplasia benigna de próstata para atención primaria

2009; Elsevier BV; Volume: 42; Issue: 1 Linguagem: Inglês

10.1016/j.aprim.2009.07.006

1885-8570

José Molero, David Pérez Morales, Francisco José Brenes Bermúdez, Esperanza Pulido, A. Fernández-Pro, Juan Antonio Martín, Jesús Castiñeiras Fernández, José Manuel Cózar Olmo,

Hormonal and reproductive studies

Benign prostatic hyperplasia (BPH) is a high prevalence condition in men over 50 years that requires continued assistance between primary care and urology. Therefore, consensus around common referral criteria was needed to guide and support both levels. Medical history, symptom assessment with International Prostate Symptom Score (IPSS) questionnaire, digital rectal examination and prostate-specific antigen (PSA) measurement are diagnostic tests available for general practitioners that allow setting a correct BPH diagnose. Patients with an IPSS 1.5 ng/ml combined treatment and evaluation at the first and sixth month is recommended. Some clear criteria for referral to urology are established in this document, which help in the management of these patients. Those patients with BPH who do not show any improvement at the third month of treatment with alpha-blockers, or the sixth month with 5alpha-reductase inhibitors, will be referred to urology. Patients will also be referred to urology if they have lower urinary tract symptoms, a pathological finding during rectal examination, IPSS>20, PSA>10 ng/ml or PSA>4 ng/ml and free PSA<20% or if they are <50 years with suspected BHP, or if they have any urological complication.