Speakman Mark, Kirby Roger, Doyle Scott, Ioannou Chris
Department of Urology, Musgrove Park Hospital, Taunton, UK.
BJU Int. 2015 Apr;115(4):508-19. doi: 10.1111/bju.12745. Epub 2014 Oct 16.
Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) can be bothersome and negatively impact on a patient's quality of life (QoL). As the prevalence of LUTS/BPH increases with age, the burden on the healthcare system and society may increase due to the ageing population. This review unifies literature on the burden of LUTS/BPH on patients and society, particularly in the UK. LUTS/BPH is associated with high personal and societal costs, both in direct medical costs and indirect losses in daily functioning, and through its negative impact on QoL for patients and partners. LUTS/BPH is often underdiagnosed and undertreated. Men should be encouraged to seek medical advice for this condition and should not accept it as part of ageing, while clinicians should be more active in the identification and treatment of LUTS/BPH. To assess the burden of illness and unmet need arising from lower urinary tract symptoms (LUTS) presumed secondary to benign prostatic hyperplasia (BPH) from an individual patient and societal perspective with a focus on the UK. Embase, PubMed, the World Health Organization, the Cochrane Database of Systematic Reviews and the York Centre for Reviews and Dissemination were searched to identify studies on the epidemiological, humanistic or economic burden of LUTS/BPH published in English between October 2001 and January 2013. Data were extracted and the quality of the studies was assessed for inclusion. UK data were reported; in the absence of UK data, European and USA data were provided. In all, 374 abstracts were identified, 104 full papers were assessed and 33 papers met the inclusion criteria and were included in the review. An additional paper was included in the review upon a revision in 2014. The papers show that LUTS are common in the UK, affecting ≈3% of men aged 45-49 years, rising to >30% in men aged ≥85 years. European and USA studies have reported the major impact of LUTS on quality of life of the patient and their partner. LUTS are associated with high personal and societal costs, both in direct medical costs and indirect losses in daily functioning. While treatment costs in the UK are relatively low compared with other countries, the burden on health services is still substantial. LUTS associated with BPH is a highly impactful condition that is often undertreated. LUTS/BPH have a major impact on men, their families, health services and society. Men with LUTS secondary to BPH should not simply accept their symptoms as part of ageing, but should be encouraged to consult their physicians if they have bothersome symptoms.
与良性前列腺增生(BPH)相关的下尿路症状(LUTS)可能会令人烦恼,并对患者的生活质量(QoL)产生负面影响。随着LUTS/BPH的患病率随年龄增长而增加,由于人口老龄化,医疗系统和社会的负担可能会加重。本综述整合了关于LUTS/BPH对患者和社会负担的文献,特别是在英国。LUTS/BPH与高昂的个人和社会成本相关,包括直接医疗成本和日常功能的间接损失,以及对患者及其伴侣生活质量的负面影响。LUTS/BPH常常诊断不足和治疗不足。应鼓励男性针对这种情况寻求医疗建议,不应将其视为衰老的一部分,而临床医生应更积极地识别和治疗LUTS/BPH。从个体患者和社会角度评估继发于良性前列腺增生(BPH)的下尿路症状(LUTS)所产生的疾病负担和未满足的需求,重点关注英国。检索了Embase、PubMed、世界卫生组织、Cochrane系统评价数据库和约克评价与传播中心,以识别2001年10月至2013年1月期间以英文发表的关于LUTS/BPH的流行病学、人文或经济负担的研究。提取数据并评估研究质量以确定是否纳入。报告了英国的数据;在没有英国数据的情况下,提供了欧洲和美国的数据。总共识别出374篇摘要,评估了104篇全文,33篇论文符合纳入标准并被纳入综述。2014年修订后又纳入了一篇论文。这些论文表明,LUTS在英国很常见,影响约3%的45 - 49岁男性,在85岁及以上男性中升至30%以上。欧洲和美国的研究报告了LUTS对患者及其伴侣生活质量的重大影响。LUTS与高昂的个人和社会成本相关,包括直接医疗成本和日常功能的间接损失。虽然与其他国家相比,英国的治疗成本相对较低,但对卫生服务的负担仍然很大。与BPH相关的LUTS是一种影响重大但常常治疗不足的疾病。LUTS/BPH对男性、他们的家庭、卫生服务和社会都有重大影响。继发于BPH的LUTS男性不应简单地将其症状视为衰老的一部分,如果他们有令人烦恼的症状,应鼓励他们咨询医生。