Ensure emptying of the bladder during day time or before long trips to avoid overflow incontinence and urgency: pelvic floor exercises, encourage a heart healthy lifestyle and regular physical exercise, stop smoking. If the patient has diabetes mellitus, dyslipidemia, or hypertension, optimize management. In patients with mild disease (asymptomatic or mild bothersome symptoms and no complications of bph): watchful waiting. At each visit, assess the patient"s risk of developing acute urinary retention by evaluating the patient"s prostate size (using. Efficacy: a clinically significant improvement is associated with a decrease in score of 3 points or more. The efficacy of any new medication should be assessed 6-12 weeks after its start. All pharmacologic options resulted in a clinically important decrease in the aua-si score (3 points or more), especially alpha-adrenergic blockers and 5-alpha reductase inhibitors which resulted in a decrease of more than 4 points.