Key Points

• Benign prostatic hyperplasia affects most men by age 80 years. Lower urinary tract symptoms vary and may not correlate with prostate size. Other factors such as detrusor dysfunction contribute to LUTS.

• Alpha-adrenergic antagonists and 5a-reductase inhibitors are effective for BPH and LUTS.

• Smoking is the top risk factor for bladder cancer, and hematuria is the most common presenting sign.

• Prostate cancer is the most common cancer in men and second most common cause of male cancer death.

• There is no PSA value that is both sensitive and specific for prostate cancer.

• When ordering a PSA test, family physicians should discuss the risk, benefits, and uncertainties with patients and make a shared decision about whether to screen.

• The value of testicular self-examination is unknown.

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