University College Hospital, London, Backwell, UK.
BJU Int. 2011 Mar;107(6):876-80. doi: 10.1111/j.1464-410X.2010.10041.x. Epub 2011 Jan 25.
• Benign prostatic hyperplasia (BPH) is a common cause of bothersome lower urinary tract symptoms. In the past, the aim of drug treatment was to relieve symptoms until surgery became necessary, predominantly using an α-blocker or a 5α-reductase inhibitor (5ARI) as monotherapy. • Together with improving knowledge about the pathogenesis of BPH, there is now strong evidence from large randomized trials that risk stratification and appropriate treatment with combined α-blocker/5ARI therapy can significantly reduce the risk of disease progression and avoid long-term complications such as acute urinary retention and surgery. • BPH will increasingly be managed in primary care in the future and, if new management strategies based on this evidence are to be implemented cost effectively, there is a need to introduce shared care between the primary and secondary care sectors to optimise use of resources and expertise.
良性前列腺增生症（BPH）是引起下尿路症状的常见原因。在过去，药物治疗的目的是缓解症状，直到需要手术治疗，主要使用α受体阻滞剂或 5α 还原酶抑制剂（5ARI）作为单药治疗。随着对 BPH 发病机制认识的不断提高，目前来自大型随机试验的有力证据表明，通过风险分层和适当的联合 α受体阻滞剂/5ARI 治疗，可以显著降低疾病进展的风险，并避免急性尿潴留和手术等长期并发症。未来，BPH 将越来越多地在初级保健中得到管理，如果要以具有成本效益的方式实施基于这些证据的新管理策略，就需要在初级保健和二级保健部门之间引入共同护理，以优化资源和专业知识的利用。
