Department of Urology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA.
BJU Int. 2012 Nov;110(9):1332-7. doi: 10.1111/j.1464-410X.2012.10998.x. Epub 2012 Apr 3.
Study Type - Therapy (outcomes research) Level of Evidence 2c. What's known on the subject? and What does the study add? It is known that benign prostatic hyperplasia is a common condition affecting most men by the age of 80 years. There are multiple treatment options available, including both medical and surgical interventions. However, what is not known is how affective the different types of interventions are in the general population. Previous studies have focused on centre-specific data. What is unique about our study is that it is a prospective cross-section analysis of a community cohort of men. Through this study we were able to assess the outcomes in the general population as opposed to in a high-volume surgical centre. Our findings show that in this community medical management was poor at symptomatic improvement, whereas surgical intervention produced the best improvement.
• To describe the use and symptomatic outcomes of different therapies for lower urinary tract symptoms (LUTS) in a community-based population of men followed for 17 years.
• Data from a randomly selected cohort of 2184 men, aged 40-79 years in 1990, from Olmsted County, Minnesota, USA were included in the study. Participants completed a questionnaire similar to the American Urological Association Symptom Index (AUASI) and reported on incontinence. • Men were followed biennially through 2007 (median follow-up: 13.7 years; Q1, Q3: 8.8, 15.7). Medical and surgical treatments for LUTS were reported on biennial questionnaires and abstracted from community medical records.
• Overall, 610 (28%) men received medical or surgical therapy for treatment of LUTS. Patients undergoing vaporization and transurethral resection of the prostate (TURP) had the highest pre-intervention AUASI scores (P < 0.001) and the most rapid increase in scores over time (P= 0.002) compared with those treated with medications or no therapy. After intervention, symptom progression slowed in all treatment groups. • However, the greatest improvement in AUASI score (median % change) was observed in the TURP group: -27.45%. The TURP group also reported a significant decrease in incontinence after surgery (% change): TURP: -22.58%.
• All therapies were effective at slowing the progression of LUTS, but only TURP patients reported a significant decrease in both LUTS and incontinence after therapy.
研究类型 - 治疗（结局研究）证据级别 2c。 已知的是什么？ 研究增加了什么？ 良性前列腺增生是一种常见的疾病，大多数男性在 80 岁时都会受到影响。有多种治疗选择，包括药物和手术干预。然而，目前尚不清楚不同类型的干预措施在普通人群中的效果如何。以前的研究侧重于特定中心的数据。我们的研究独特之处在于，它是对一个社区队列中男性的前瞻性横断面分析。通过这项研究，我们能够评估普通人群中的治疗效果，而不是在高容量手术中心。我们的研究结果表明，在这个社区中，药物治疗在改善症状方面效果不佳，而手术干预效果最好。
描述在一个随访 17 年的社区男性人群中，不同治疗方法对下尿路症状（LUTS）的使用和症状结局。
纳入了来自美国明尼苏达州奥姆斯特德县的一个随机选择的 2184 名年龄在 40-79 岁的男性队列的数据。参与者完成了一份类似于美国泌尿协会症状指数（AUASI）的问卷，并报告了尿失禁情况。男性每两年通过 2007 年（中位随访时间：13.7 年；Q1，Q3：8.8，15.7）进行随访。LUTS 的药物和手术治疗情况通过每两年一次的问卷报告，并从社区病历中提取。
总体而言，610 名（28%）男性接受了 LUTS 的药物或手术治疗。接受汽化和经尿道前列腺切除术（TURP）的患者在干预前的 AUASI 评分最高（P < 0.001），并且随着时间的推移评分增加最快（P= 0.002），与接受药物治疗或无治疗的患者相比。干预后，所有治疗组的症状进展均减缓。然而，TURP 组的 AUASI 评分改善最大（中位数%变化）：-27.45%。TURP 组在手术后尿失禁的发生率也显著下降（%变化）：TURP：-22.58%。
所有治疗方法均能有效减缓 LUTS 的进展，但只有 TURP 患者在治疗后报告 LUTS 和尿失禁均有显著改善。
