Figure 13.

PSA-based algorithm for treatment of men with BPH. In this schema, data from the MTOPS study⁶ is employed to suggest combination therapy with a 5ARI and an α-blocking agent for symptomatic men with high PSA levels (right side), whereas men with few symptoms and low PSA levels need only be observed (left side). Men with symptoms and low PSA levels would be treated with an α-blocker alone (right center, bottom). Men with few symptoms but elevated PSA levels would be offered preventive therapy with a 5ARI (left center, bottom), as discussed elsewhere.¹⁰ This schema is solely the author’s notion and does not reflect the package inserts. PSA, prostate-specific antigen; BPH, benign prostatic hyperplasia; MTOPS, Medical Therapy of Prostatic Symptoms; 5ARI, 5α-reductase inhibitor; IPSS, International Prostate Symptom Score.