Stovsky Mark D, Rhee Katherine, Hartke David
Department of Urology, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
Curr Urol Rep. 2007 Jul;8(4):289-97. doi: 10.1007/s11934-007-0075-8.
From a clinical standpoint, the emergence of selective pharmacologic therapies and minimally invasive procedural treatments has changed clinical management paradigms for benign prostatic hyperplasia (BPH). Choosing from among the available treatment options can be complex for both patient and physician as factors including clinical outcomes, cost, and reimbursement are weighed and evaluated. Pharmacologic therapies produce modest improvements in objective outcomes measures and subject patients to long-term costs and risks including disease progression and the potential need for subsequent procedural treatment. Procedural interventions for obstructive BPH have changed dramatically in the past several decades as minimally invasive therapies have been developed to produce substantial improvement in outcomes measures and limit the potential morbidity associated with traditional surgical therapies. This paper reviews the current literature to provide a framework for understanding the relationship between clinical outcomes and costs with respect to commonly used medical and procedural therapies for the management of symptomatic BPH and associated lower urinary tract symptoms. The objective is to provide the clinician with an assessment of peer-reviewed evidence-based data to facilitate informed decision making on patient treatment for obstructive BPH.
从临床角度来看，选择性药物治疗和微创治疗方法的出现改变了良性前列腺增生（BPH）的临床管理模式。对患者和医生而言，在现有治疗方案中进行选择可能很复杂，因为需要权衡和评估包括临床结果、成本和报销等因素。药物治疗在客观结果指标方面有适度改善，但会使患者承担长期成本和风险，包括疾病进展以及后续可能需要进行手术治疗。在过去几十年中，针对梗阻性BPH的手术干预发生了巨大变化，因为已开发出微创治疗方法，可在结果指标上产生显著改善，并限制与传统手术治疗相关的潜在发病率。本文回顾了当前文献，以提供一个框架，用于理解在治疗有症状的BPH及相关下尿路症状时，常用药物和手术治疗的临床结果与成本之间的关系。目的是为临床医生提供经同行评审的循证数据评估，以便在治疗梗阻性BPH患者时做出明智的决策。
