Does Delaying Surgical Treatment of BPH Affect Long-Term Outcomes?

Purpose of ReviewLower urinary tract symptoms due to bladder outlet obstruction are a significant health issue affecting millions of men in the USA. Pharmacotherapy has been successfully used to control symptoms and is the first line therapy. However, prolonged medical therapy does not prevent disease progression and can lead to significant delays in transurethral surgery. The disease progression has shown to be associated with the development of complications such as acute urinary retention and the need for catheterization leading to worse long-term outcomes after BPH surgery. Herein, we review literature identifying factors leading to disease progression as well as surgical outcomes to establish whether earlier surgery would be beneficial to men with BPH.Recent FindingsBPH is a progressive disease leading to complications like acute urinary retention which can cause bladder remodeling and potentially irreversible voiding function in older men. Recent study by Frendl et al. with a 10-year follow-up has shown that men undergoing delayed surgery for BPH in a setting of acute urinary retention and catheterization have worse long-term outcomes.SummaryEvidence suggests that delay of surgery for BPH leads to worse short and long-term outcomes. Men at risk for disease progression and its complications may benefit from earlier surgical intervention.