What are the UAU guidelines on anticholinergic drugs for the management of benign prostatic hyperplasia (BPH)?

Updated: Feb 19, 2021
  • Author: Levi A Deters, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Historically, anticholinergics were discouraged in men with BPH because of concerns of inducing urinary retention. Trials in patients with BPH have demonstrated a slight increase in post-void residual (PVR) urine volume with the use of anticholinergics; however, acute urinary retention rates were low. Importantly, these trials consisted of patients with low baseline PVR.

The American Urological Association BPH guidelines recommend anticholinergic agents for management of LUTS in patients who do not have an elevated PVR volume and whose LUTS are primarily irritative. Baseline PVR should be measured prior to initiation of anticholinergic therapy, to assess for urinary retention. [29]  Caution with anticholinergics is recommended with patients whose PVR is greater than 250-300 mL. [1]

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