Treatment Plan
Voiding symptoms:
- Alpha-blockers (alfuzosin) if IPSS >8
- Review 4-6 weeks, then 6 monthly with IPSS
- Consider 5-alpha reductase inhibitors (finasteride) if:
Prostate >30g
PSA ≥1.4 ng/ml
Moderate-severe IPSS Storage symptoms:
- Conservative: pads, collecting devices, supervised bladder training
- Antimuscarinics (if conservative measures fail)
- Mirabegron (elderly patients) Nocturnal polyuria:
- Furosemide 40mg
- Oral desmopressin (monitor sodium at 3 days) Acute retention:
- Admission and catheterisation
- Alfuzosin 10mg OD before catheter removal
- Consider intermittent/long-term catheter
- Chronic cases: refer