Barkin Jack
Humber River Regional Hospital, University of Toronto, Toronto, Ontario, Canada.
Can J Urol. 2011 Apr;18 Suppl:14-9.
Significant lower urinary tract symptoms (LUTS) are very common in men over age 50. It is appropriate for the primary care physician to perform the work up to confirm that benign prostatic hyperplasia (BPH) is causing the LUTS. If the physician determines that the patient has moderate symptoms (an International Prostate Symptom Score [IPSS] ≥ 8), moderate 'bother' (≥ 3 on the IPSS "bothersome index" question), and an enlarged (> 30 cc) prostate, then the most effective treatment is combination therapy with an alpha blocker and 5-alpha reductase inhibitor (5-ARI) at the time of confirmed BPH diagnosis. This combination will provide the most dramatic, early symptom response, the most sustained symptom response, and the most durable, reliable prevention of long term sequelae (acute urinary retention or the need for surgery), if the patient is compliant with taking the combination therapy.
严重下尿路症状（LUTS）在50岁以上男性中非常常见。初级保健医生进行相关检查以确认良性前列腺增生（BPH）是导致LUTS的病因是恰当的。如果医生确定患者有中度症状（国际前列腺症状评分[IPSS]≥8）、中度“困扰”（IPSS“困扰指数”问题≥3）且前列腺增大（>30立方厘米），那么在确诊BPH时，最有效的治疗方法是α受体阻滞剂与5-α还原酶抑制剂（5-ARI）联合治疗。如果患者坚持联合治疗，这种联合治疗将提供最显著的早期症状缓解、最持久的症状缓解，以及对长期后遗症（急性尿潴留或手术需求）最持久、可靠的预防。
