Don’t order creatinine or upper-tract imaging for patients with benign prostatic hyper-plasia.
|Rationale and Comments:||When an initial evaluation shows only the presence of lower urinary tract symptoms, if the symptoms are not significantly bothersome to the patient or if the patient doesn’t desire treatment, no further evaluation is recommended. Such patients are unlikely to experience significant health problems in the future due to their condition and can be seen again if necessary. While the patient can often tell the provider if the symptoms are bothersome enough that he desires additional therapy, another possible option is to use a validated questionnaire to assess symptoms. For example, if the patient completes the International Prostate Symptom Scale and has a symptom score of 8 or greater, this is considered to be "clinically" bothersome.|
|References:||• American Urological Association. Management of the benign prostatic hyperplasia clinical practice guideline. http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm?sub=bph.|