Abrams P, Chapple C, Khoury S, Roehrborn C, de la Rosette J
J Urol. 2009 Apr;181(4):1779-87. doi: 10.1016/j.juro.2008.11.127. Epub 2009 Feb 23.
The 6th International Consultation on New Developments in Prostate Cancer and Prostate Diseases met from June 24-28, 2005 in Paris, France to review new developments in benign prostatic disease.
A series of committees were asked to produce recommendations on the evaluation and treatment of lower urinary tract symptoms in older men. Each committee was asked to base recommendations on a thorough assessment of the available literature according to the International Consultation on Incontinence level of evidence and grading system adapted from the Oxford system.
The Consultation endorsed the appropriate use of the current terminology lower urinary tract symptoms/benign prostatic hyperplasia/benign prostate enlargement and benign prostatic obstruction, and recommended that terms such as "clinical benign prostatic hyperplasia" or "the benign prostatic hyperplasia patient" be abandoned, and asked the authorities to endorse the new nomenclature. The diagnostic evaluation describes recommended and optional tests, and in general places the focus on the impact (bother) of lower urinary tract symptoms on the individual patient when determining investigation and treatment. The importance of symptom assessment, impact on quality of life, physical examination and urinalysis is emphasized. The frequency volume chart is recommended when nocturia is a bothersome symptom to exclude nocturnal polyuria. The recommendations are summarized in 2 algorithms, 1 for basic management and 1 for specialized management of persistent bothersome lower urinary tract symptoms.
The use of urodynamics and transrectal ultrasound should be limited to situations in which the results are likely to benefit the patient such as in selection for surgery. It is emphasized that imaging and endoscopy of the urinary tract have specific indications such as dipstick hematuria. Treatment should be holistic, and may include conservative measures, lifestyle interventions and behavioral modifications as well as medication and surgery. Only treatments with a strong evidence base for their clinical effectiveness should be used.
第六届前列腺癌及前列腺疾病新进展国际咨询会议于2005年6月24日至28日在法国巴黎召开，旨在回顾良性前列腺疾病的新进展。
一系列委员会被要求就老年男性下尿路症状的评估和治疗提出建议。每个委员会被要求根据国际尿失禁咨询委员会的证据水平和源自牛津系统的分级系统，对现有文献进行全面评估后提出建议。
本次咨询会议认可了当前术语“下尿路症状/良性前列腺增生/良性前列腺肿大”和“良性前列腺梗阻”的恰当使用，建议摒弃诸如“临床良性前列腺增生”或“良性前列腺增生患者”等术语，并要求相关权威机构认可新的命名法。诊断评估描述了推荐和可选的检查项目，并且在确定检查和治疗时，总体上关注下尿路症状对个体患者的影响（困扰程度）。强调了症状评估、对生活质量的影响、体格检查和尿液分析的重要性。当夜尿症是一个困扰症状时，推荐使用频率-尿量图表以排除夜间多尿。这些建议总结在2个算法中，1个用于基本管理，1个用于持续性困扰性下尿路症状的专科管理。
尿动力学检查和经直肠超声检查的应用应限于结果可能使患者受益的情况，如手术选择时。强调尿路成像和内镜检查有特定的适应证，如试纸法血尿。治疗应是整体性的，可能包括保守措施、生活方式干预和行为改变以及药物治疗和手术。仅应使用有强有力临床疗效证据基础的治疗方法。
