The paradigm for the medical management of benign prostatic hyperplasia (BPH) has undergone significant changes over the past two decades. What was once a two-option field, that is do nothing or perform a transurethral resection of the prostate, has exploded into a virtual smorgasbord of therapies. With the advent of cutting-edge research, the approval of novel pharmaceutical and minimally invasive therapies and the economics of health-care financing, physicians have altered their approach to patient care in distinct ways. This evolution in thinking continues today. Moreover, as novel therapeutic modalities become available, as new connections between symptoms, sexual function and metabolic dysfunction become identified, and as we learn which baseline parameters best predict treatment response in particular patient populations, the therapeutic paradigm is likely to evolve and progress still further.
In addition to emerging treatment paradigms, BPH has now become a more universal disease, with primary care physicians increasingly involved in developing and sustaining treatment strategies. It is, therefore, a good time to coalesce many of these new diagnostic and therapeutic algorithms into a cohesive series of articles that has been titled ‘BPH and Sexual Dysfunction for the Primary care Physician.’ The objective of this supplement to The International Journal of Impotence Research is to provide an update for the primary care physicians and other interested health-care providers on new perspectives in the management of BPH and the strong association with sexual dysfunction. Specifically, the goals of this supplement are to (1) differentiate the safety and efficacy of α-blockers to treat BPH; (2) increase the primary care physician's knowledge and expertise in the management of BPH through interaction with the urologist; (3) clarification of new treatment regimens and combination medical therapies; and (4) distinguish between the numerous overlapping syndromes/comorbidities with lower urinary tract symptoms and the ensuing challenges in diagnosis and treatment. I am grateful to all of the authors for their scholarly contributions to this project and I am sure you will agree after reading this supplement that all these objectives have been met.
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