[International comparison of guidelines for the management of benign prostatic hyperplasia: use of a validated generic tool].

INTRODUCTION

Many clinical practice guidelines (CPG) have been developed over the last decade for the management of benign prostatic hyperplasia (BPH) and associated lower urinary tract disorders. The purpose of this study was to analyse CPG published on the web until the end of 2001 and to compare their content and their methodology of development by using a validated evaluation tool. methodologies of development of CPG and their content using a validated tool.

RESULTS

The methodology of elaboration and presentation of CPG was insufficient in the majority of CPGs. The type and number of diagnostic examinations recommended by each CPG were very variable. A consensus concerning treatment was reached at the cost of poorly defined criteria, apart from complications of BPH.

CONCLUSION

The considerable number of men potentially eligible for management of voiding disorders related to BPH in the years to come will constitute a substantial medico-economic burden. Consensual rationalisation of this management by urologists in order to ensure practical application of the guidelines would limit expenditure without decreasing the quality of patient management. However, our study showed limited coherence between the various CPG, suggesting that rationalisation should first be applied to the method of development of CPG.