Educational Objectives

At the conclusion of this educational activity, participants should be better prepared to: 

  • Describe pathophysiologic mechanisms in benign prostatic hyperplasia and lower urinary tract symptoms (BPH-LUTS) and relationships to comorbid conditions and therapeutic approaches 
  • Conduct comprehensive assessments of patients with suspected BPH and associated LUTS 
  • Evaluate the mechanisms of action and clinical profiles of α-blockers, 5-α reductase inhibitors (5-ARIs), and phosphodiesterase type 5 (PDE-5) inhibitors in the treatment of BPH-LUTS with and without ED
  • Combine pharmacologic and nonpharmacologic interventions for BPH-LUTS based on symptom severity, common comorbidities, risk of disease progression, and patient goals
  • Monitor treatment efficacy and adherence in patients with BPH-LUTS to guide therapeutic restructuring and optimize patient outcomes

Needs Assessment and Learner’s Gap

Benign prostatic hyperplasia (BPH) is a histologic condition characterized by increased numbers of prostatic stromal and epithelial cells.1 In many men, the resulting prostate growth together with increased endothelial smooth muscle contraction will obstruct the bladder outlet, reduce urine flow, and cause a range of lower urinary tract symptoms (LUTS).1,2 A heterogeneous condition, LUTS vary in severity and functional impact among the 20 to 35 million affected men with BPH.3 Common LUTS include frequency, hesitancy, and straining to urinate; incomplete emptying of the bladder; nocturia; urgency; and weak urine stream.4 Traditionally managed in urology practices, BPH-LUTS is increasingly being diagnosed and treated in primary care.4,5 This Interactive Exchange™ program will examine current insights into BPH-LUTS disease mechanisms and treatments that target underlying pathologic processes. Evidence-based recommendations for symptom evaluation, comprehensive patient-centered approaches to therapy, and clinical presentations of complex cases will be central to the interactive discussion.6,7

Intended Audience

This activity is intended for primary care providers (PCPs) involved in the assessment, diagnosis, and long-term management of patients with BPH-LUTS.

There are no prerequisites for this educational activity. 

References

  1. Lepor H. Pathophysiology of benign prostatic hyperplasia in the aging male population. Rev Urol. 2005; 7 (suppl 4): S3-S12.
  2. McVary KT. BPH: epidemiology and comorbidities. Am J Manag Care. 2006; 12(suppl 5): S122-S128.
  3. Rosenberg MT, Staskin DR, Kaplan SA, MacDiarmid SA, Newman DK, Ohl DA. A practical guide to the evaluation and treatment of male lower urinary tract symptoms in the primary care setting. Int J Clin Pract. 2007; 61(9): 1535-1546.
  4. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002; 21(2): 167-178.
  5. Dmochowski RR, Gomelsky A. Update on the treatment of overactive bladder. Curr Opin Urol. 2011; 21(4): 286-290.
  6. Roehrborn CG. Male lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). Med Clin North Am. 2011; 95(1): 87-100.
  7. Gacci M, Eardley I, Giuliano F, et al. Critical analysis of the relationship between sexual dysfunctions and lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol. 2011; 60(4): 809-825.

Faculty

Steven A. Kaplan, MD
E. Darracott Vaughan Jr. Professor of Urology
Chief, Institute for Bladder and Prostate Health
Weill Cornell Medical College
Director, Iris Cantor Men’s Health Center
New York Presbyterian Hospital
Weill Cornell Medical Center
New York, New York

Matt T. Rosenberg, MD
Medical Director
Mid-Michigan Health Centers
Chief, Department of Family Medicine
Foote Health System
Jackson, Michigan

David R. Staskin, MD
Associate Professor of Urology
Tufts University School of Medicine
Director, Center for Male and Female Pelvic Health
Steward-St. Elizabeth’s Medical Center
Boston, Massachusetts

Accreditation Statement 

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Educational Review Systems, Inc., and Integritas Communications.

Credit Designation

This program has been reviewed and is acceptable for up to 1.0 Prescribed credit hour by The American Academy of Family Physicians.  AAFP Prescribed credit is accepted by the AMA as equivalent to AMA PRA Category 1 Credit™ for the American Medical Association (AMA) Physician’s Recognition Award (PRA). When applying for the AMA PRA, Prescribed hours earned must be reported as Prescribed hours, not as Category 1. (This statement applies to all Physicians, not just Family Physicians.)

Conflict of Interest Statement

The Conflict of Interest Disclosure Policy of Educational Review Systems, Inc., requires that faculty participating in any CME activity disclose to the audience any relationship(s) with a pharmaceutical, product, or device company. Any presenter whose disclosed relationships prove to create a conflict of interest with regard to his/her contribution to the activity will not be permitted to present.  

Educational Review Systems, Inc., also requires that faculty participating in any CME activity and anyone in a position to influence content disclose to the audience when discussing any unlabeled or investigational use of any commercial product, or device, not yet approved for use in the United States.

Faculty and Planning Committee Disclosures

Steven A. Kaplan, MD
Has no relevant financial relationships to disclose

Matt T. Rosenberg, MD
Astellas Pharma US, Inc., Eli Lilly and Company, Horizon Pharma, Pfizer Inc. (Consultant, Speakers Bureau)

David R. Staskin, MD
Allergan, Inc. (Consultant, Speakers Bureau); AltheRx Pharmaceuticals (Consultant); Astellas Pharma US, Inc. (Consultant, Speakers Bureau); Endo Pharmaceuticals, Inc./American Medical Systems (Consultant, Inventor, Speakers Bureau)

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