Weibl Peter, Klatte Tobias, Laurinc Peter, Tomaškin Roman, Shariat Shahrokh F, Helbich Miroslav, Fackovcova Danica, Bujdák Peter
Department of Urology, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria,
Wien Klin Wochenschr. 2015 May;127(9-10):363-8. doi: 10.1007/s00508-014-0668-4. Epub 2014 Dec 2.
The aim of the study was to evaluate patients attitudes with benign prostatic hyperplasia at the risk of progression during a 12-month period of observation.
A total of 426 patients from 45 outpatients centers were included and prospectively followed. Inclusion criteria were: age > 50 years, International Prostate Symptom Score (IPSS) > 8, prostate volume > 30 cm(3) (transabdominal ultrasound) and PSA > 1.5 to < 10 ng/ml.
In all, 28.6% patients were naive, 62.9% used monotherapy (alpha-blocker), and 8.5% combined treatment (alpha-blocker/5alpha-reductase inhibitor/dutasteride). The most bothersome symptoms were the weak urine stream (60.8%) and nocturia (59.2%). Patients expectations from the treatment were stabilization of the disease and reducing the risk of surgery rather than rapid resolution of symptoms. Despite the presence of symptoms, 2.3% patients claimed that benign prostatic hyperplasia/lower urinary tract symptoms had no impact on their quality of life (QoL), in 48.1 % only little impact on QoL, and 47.9% patients percepted their symptoms as severe. Out of 71.4% patients treated previously, 26.5% patients were indecisive about the satisfaction of present treatment. Visual analog score was percepted more optimistically rather than the IPSS. Pearson's correlation r = 0.68 at the beginning and r = 0.83 at the end of the study.
Prostate and Expectations of Treatment Epidemiology Research study highlights and reflects on patients behavior and self-perception, patients self-perception of the disease and therapeutic priorities during the 1 year of observation.
本研究旨在评估良性前列腺增生患者在12个月观察期内疾病进展风险的态度。
纳入45个门诊中心的426例患者并进行前瞻性随访。纳入标准为:年龄>50岁,国际前列腺症状评分(IPSS)>8,前列腺体积>30 cm³(经腹超声),前列腺特异性抗原(PSA)>1.5至<10 ng/ml。
总体而言,28.6%的患者未接受过治疗,62.9%使用单一疗法(α受体阻滞剂),8.5%采用联合治疗(α受体阻滞剂/5α还原酶抑制剂/度他雄胺)。最困扰的症状是尿流无力(60.8%)和夜尿症(59.2%)。患者对治疗的期望是疾病稳定和降低手术风险,而非症状快速缓解。尽管存在症状,但2.3%的患者称良性前列腺增生/下尿路症状对其生活质量(QoL)无影响,48.1%的患者认为对QoL影响很小,47.9%的患者认为其症状严重。在71.4%之前接受过治疗的患者中,26.5%的患者对当前治疗的满意度犹豫不决。视觉模拟评分比IPSS更乐观。研究开始时皮尔逊相关系数r = 0.68,研究结束时r = 0.83。
前列腺与治疗期望流行病学研究突出并反映了患者在1年观察期内的行为和自我认知、患者对疾病的自我认知以及治疗重点。