Sievert Karl-Dietrich, Kunit Thomas
aDepartment of Urology, University of Vienna Hospital, Vienna bDepartment of Urology, Paracelsus Medical University Salzburg, Salzburg, Austria.
Curr Opin Urol. 2017 May;27(3):287-292. doi: 10.1097/MOU.0000000000000386.
Benign prostatic enlargement is a common age-related condition, affecting over 50% of men aged more than 60 years. Side effects of medical therapy and significant morbidity of transurethral resection of the prostate and open surgery led to the development of so-called minimally invasive procedures, with the aim to be efficient but with less morbidity and shorter or no hospitalization. For this review, a systematic literature was performed. We report recent results in different treatment options for benign prostate hypoplasia (BPH) and recommend the best minimal-invasive treatment for BPH.
Within recent years, BPH surgical interventions underwent a shift. Although standard techniques have further improved because of new products and increased business competition, there has been a request from healthcare administration to reduce costs and inpatient treatment. As important, the patients understanding of outcome, fast relief, and recovery might change the common urological outcome measurement. The two main aspects are quality of life and sexuality.
Some of the presented treatments are already established in EAU guidelines, others may be recognized in clinical practice as a suitable alternative treatment to transurethral resection of the prostate and medical therapy. Patients now wish to be more involved in the treatment option decision-making and seem very concerned about side effects and their return to normal life. However, variations in reimbursements allowed in different countries can affect the treatment option.
良性前列腺增生是一种常见的与年龄相关的疾病，影响超过50%的60岁以上男性。药物治疗的副作用以及经尿道前列腺切除术和开放手术的高发病率促使了所谓的微创手术的发展，其目的是高效但发病率更低、住院时间更短或无需住院。为此综述进行了系统的文献检索。我们报告了良性前列腺增生（BPH）不同治疗选择的近期结果，并推荐了BPH的最佳微创治疗方法。
近年来，BPH的外科干预发生了转变。尽管由于新产品和商业竞争加剧，标准技术有了进一步改进，但医疗管理部门要求降低成本和减少住院治疗。同样重要的是，患者对治疗结果、快速缓解和康复的理解可能会改变常见的泌尿外科疗效评估标准。两个主要方面是生活质量和性功能。
一些所介绍的治疗方法已被纳入欧洲泌尿外科学会（EAU）指南，其他方法在临床实践中可能被视为经尿道前列腺切除术和药物治疗的合适替代治疗方法。患者现在希望更多地参与治疗方案的决策，并且似乎非常关注副作用以及恢复正常生活的情况。然而，不同国家报销政策的差异可能会影响治疗选择。
