Assessment
- Tools: Use the IPSS (International Prostate Symptom Score) to quantify severity.
- Examination: Digital Rectal Examination (DRE) is mandatory to assess size, contour, and nodules.
- Testing: Frequency-volume chart (if nocturia dominates), Dipstick (rule out UTI/Haematuria), and PSA (if symptomatic and informed consent given).
Medical Management
- Moderate/Severe Symptoms: Alpha-blocker (e.g., Tamsulosin 400mcg od). Rapid onset (days). Warn about postural hypotension.
- Prostate >30g or PSA >1.4: 5-alpha reductase inhibitor (e.g., Finasteride 5mg od). Slow onset (up to 6 months). Note: PSA will be halved by 5-ARIs; adjust interpretation accordingly.
- Storage Symptoms (Overactive bladder): Add Anticholinergic (e.g., Solifenacin) if Alpha-blocker alone is insufficient.
Transparency
This page is an educational, clinician-written summary of publicly available NICE guidance intended for trained healthcare professionals. It uses original wording (not copied text) and should be used alongside the full NICE source, local pathways, and clinical judgement. Doses provided are for general reference; always check the BNF/SPC.