Benign Prostatic Hyperplasia, Lower Urinary Tract Symptoms, and Erectile Dysfunction: Building Best Practices in Long-Term Management

Claus G. Roehrborn, MD; Gregory A. Broderick, MD; David R. Staskin, MD
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Jointly sponsored by Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center, and Asante Communications, LLC.

This activity is supported by an educational grant from Lilly USA, LLC. For further information concerning Lilly grant funding visit

Intended Audiences

This continuing medical education activity is designed for urologists,endocrinologists, primary care physicians (PCPs), and other healthcare providers who treat patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia with or without erectile dysfunction (BPH-LUTS±ED).

Learning Objectives

At the completion of this activity, participants should be better prepared to:

  1. Conduct an initial and ongoing assessment of patients with BPH, addressing LUTS, ED, coexisting disorders, patient quality of life, and function
  2. Evaluate the risk of BPH disease progression and complications
  3. Evaluate the clinical profiles and utility of 5alpha-reductase inhibitors (5-ARI), alpha blockers, and phosphodiesterase inhibitors (PDE5s) for patients with BPH-LUTS±ED
  4. Tailor monotherapy and multidrug regimens for patients with BPH-LUTS based in part on signs and symptoms, prior medication history, ED and other common comorbidities, risk of disease progression, and patient goals
  5. Teach patients with BPH-LUTS±ED practical self-management approaches and behavioral modifications to slow disease progression

Needs Assessment and Learner’s Gap

BPH is a pathologic diagnosis characterized primarily by proliferation of prostatic stromal and epithelial cells, enlargement of the prostate, ultimate bladder obstruction, and LUTS, a constellation comprising urinary frequency, hesitancy, and intermittency; incomplete voiding; weak urine stream; nocturia; and urgency.1 Highly prevalent and often underdiagnosed, BPH-LUTS is a chronic and progressive condition that greatly increases functional impairment and diminishes quality of life.2-4 In particular, symptoms adversely affect daily activities, reduce sleep quality, increase worry about overall health, and interfere with sexual relationships.1 Coexisting disorders—especially ED—frequently complicate assessment and ongoing treatment.5-7 Epidemiologic and clinical data support a pathophysiologic relationship between the conditions, although more studies are needed to elucidate underlying etiologies and their practical implications for patient care.5

Multidimensional assessment of BPH-LUTS±ED is critical to individualized treatment, now facilitated by an array of pharmacologic and behavioral therapies. Treatment for BPH-LUTS±ED is largely symptomatic and directed toward improved patient function and quality of life. Level 1 evidence supports currently available monotherapy and multidrug regimens and their ability to ameliorate urinary symptoms and disease progression.8-10 Despite the significant burden of BPH-LUTS±ED on patients and their families, the condition is frequently underreported and undertreated. Urologists and other healthcare providers who treat patients with BPH-LUTS±ED face diagnostic and therapeutic challenges for which cutting-edge insights into evidence-based best practices are needed for improved long-term outcomes. This evidencebased, interactive educational activity is designed to enhance the clinician’s understanding of the complex, interrelated nature of BPH, LUTS, and ED, and best practices for initial and ongoing management.


  1. Roehrborn CG. Int J Impot Res. 2008;20(suppl 3):S11-S18.
  2. Rosenberg MT, et al. Int J Clin Pract. 2010;64(4):488-496.
  3. DeCastro J, Stone B. Am J Med. 2008;121(8 suppl 2):S27-S33.
  4. McVary KT. Am J Manag Care. 2006;12(5 suppl):S122-S128.
  5. Orabi H, et al. Int J Impot Res. 2011;23(3):99-108.
  6. Aslan G, et al. Arch Androl. 2006;52(3):155-162.
  7. Martin DJ, Mulhall JP. Int J Clin Pract. 2005;59(5):579-590.
  8. McConnell JD, et al. N Engl J Med. 2003;349(25):2387-2398.
  9. Hollingsworth JM, et al. J Urol. 2009;182(5):2410-2414.
  10. Greco KA, McVary KT. Int J Impot Res. 2008;20(suppl 3):S33-S43.

Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Albert Einstein College of Medicine, Montefiore Medical Center, and Asante Communications. Albert Einstein College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation

Albert Einstein College of Medicine designates this live activity for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Conflict of Interest Statement

The Conflict of Interest Disclosure Policy of Albert Einstein College of Medicine requires that faculty participating in any CME activity disclose to the audience any relationship(s) with a pharmaceutical, product, or device company. Presenters whose disclosed relationships prove to create a conflict of interest with regard to their contribution to the activity will not be permitted to present. Albert Einstein College of Medicine also requires that faculty participating in any CME activity and anyone in a position to influence content disclose to the audience when discussing any unlabeled or investigational use of any commercial product or device not yet approved for use in the United States.

Faculty and Planning Committee Disclosures

Gregory A. Broderick, MD—Lilly USA, LLC (Grant/Research); WILEX AG (Grant/Research)

Claus G. Roehrborn, MD—Allergan, Inc. (Consultant); GlaxoSmithKline (Consultant); Lilly USA, LLC (Consultant, Speakers Bureau); NeoTract, Inc. (Grant/Research); Sophiris Bio Inc. (Consultant)

David R. Staskin, MD—Allergan, Inc. (Consultant, Speakers Bureau); AltheRx Pharmaceuticals (Consultant); Astellas Pharma US, Inc. (Consultant, Speakers Bureau); Takeda Pharmaceutical Company Limited (Consultant); Watson Pharmaceuticals, Inc. (Speakers Bureau)

David M. Hoenig, MD—Luitpold Pharmaceuticals, Inc. (Grant/Research) Steven Jay Feld of Albert Einstein College of Medicine, or a member of his household, owns securities in Bioheart, Inc.; Chelsea Therapeutics, Inc.; and Pharmacopeia, Inc.

Christopher S. Ontiveros, PhD, of Asante Communications has no relevant financial relationships to disclose.


The opinions, ideas, recommendations, and perspectives expressed in this program and accompanying materials are those of the presenting faculty only and do not necessarily reflect the opinions, ideas, recommendations, or perspectives of their affiliated institutions, Albert Einstein College of Medicine, Montefiore Medical Center, Asante Communications, or the activity’s commercial supporter.

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