良性前列腺增生的当前治疗方法
Current Treatment for Benign Prostatic Hyperplasia.
作者信息
Miernik Arkadiusz, Gratzke Christian
机构信息
Department of Urology at University Hospital Freiburg.
出版信息
Dtsch Arztebl Int. 2020 Dec 4;117(49):843-854. doi: 10.3238/arztebl.2020.0843.
Abstract
BACKGROUND
Benign prostatic hyperplasia (BPH) is characterized by the occurrence of.disorders of urine storage and bladder emptying. Most men over the age of 60 years are affected to some degree.
METHODS
A selective literature search with additional scrutiny of guidelines and meta-analyses.
RESULTS
The management of patients with BPH is complex. Emptying and retention disorders can be treated by various pharmacological and surgical means. Transurethral resection of the prostate (TURP) has long been considered the gold standard for operative treatment. Transurethral enucleation procedures show a better risk profile in some uses, however, and have, above all, largely displaced suprapubic prostatectomy. Numerous innovative treatment options have been developed in recent years, but their long-term effects remain to be determined. These treatment techniques can nevertheless be used in individual cases after thorough discussion with the patient.
CONCLUSION
The care of patients with BPH should be interdisciplinary. The efficacy and safety of many new developments in the area of pharmacological and minimally invasive treatment remain to be demonstrated in randomized trials.
摘要
背景
良性前列腺增生（BPH）的特征是出现储尿和膀胱排空障碍。大多数60岁以上的男性会受到某种程度的影响。
方法
进行选择性文献检索，并对指南和荟萃分析进行额外审查。
结果
BPH患者的管理很复杂。排空和潴留障碍可以通过各种药物和手术方法治疗。经尿道前列腺切除术（TURP）长期以来一直被认为是手术治疗的金标准。然而，经尿道剜除术在某些应用中显示出更好的风险状况，并且最重要的是，已在很大程度上取代了耻骨上前列腺切除术。近年来已开发出许多创新的治疗选择，但其长期效果仍有待确定。不过，在与患者进行充分讨论后，这些治疗技术可用于个别病例。
结论
BPH患者的护理应是跨学科的。药理学和微创治疗领域许多新进展的疗效和安全性仍有待在随机试验中得到证实。
相似文献
1
Current Treatment for Benign Prostatic Hyperplasia.良性前列腺增生的当前治疗方法
Dtsch Arztebl Int. 2020 Dec 4;117(49):843-854. doi: 10.3238/arztebl.2020.0843.
2
Bipolar plasma enucleation of the prostate vs open prostatectomy in large benign prostatic hyperplasia cases - a medium term, prospective, randomized comparison.经尿道双极等离子前列腺剜除术与开放性前列腺切除术治疗大体积良性前列腺增生症的中期前瞻性随机对照研究。
BJU Int. 2013 May;111(5):793-803. doi: 10.1111/j.1464-410X.2012.11730.x. Epub 2013 Mar 7.
3
Management of Benign Prostatic Hyperplasia Larger than 100 ml: Simple Open Enucleation Versus Transurethral Laser Prostatectomy.大于100毫升的良性前列腺增生的管理：单纯开放性剜除术与经尿道激光前列腺切除术
Curr Urol Rep. 2016 Jun;17(6):44. doi: 10.1007/s11934-016-0601-7.
4
Feasibility of holmium laser enucleation of the prostate (HoLEP) for recurrent/residual benign prostatic hyperplasia (BPH).钬激光前列腺剜除术（HoLEP）治疗复发性/残留良性前列腺增生（BPH）的可行性。
BJU Int. 2012 Dec;110(11 Pt C):E845-50. doi: 10.1111/j.1464-410X.2012.11290.x. Epub 2012 Jun 15.
5
A Systematic Review and Meta-analysis of Functional Outcomes and Complications Following Transurethral Procedures for Lower Urinary Tract Symptoms Resulting from Benign Prostatic Obstruction: An Update.经尿道前列腺切除术治疗良性前列腺梗阻所致下尿路症状的功能结局和并发症的系统评价和荟萃分析：更新
Eur Urol. 2015 Jun;67(6):1066-1096. doi: 10.1016/j.eururo.2014.06.017. Epub 2014 Jun 25.
6
Long-term results of contact laser versus transurethral resection of the prostate in the treatment of benign prostatic hyperplasia with small or moderately enlarged prostates.接触式激光与经尿道前列腺切除术治疗前列腺轻度或中度增生的良性前列腺增生症的长期疗效比较
Scand J Urol Nephrol. 2003;37(6):487-93. doi: 10.1080/00365590310015769.
7
[Benign prostatic hyperplasia (BPH) : Surgical therapy options].[良性前列腺增生（BPH）：手术治疗方案]
Urologe A. 2010 Jan;49(1):113-26. doi: 10.1007/s00120-009-2183-1.
8
The clinical application of combination suprapubic prostatectomy with transurethral resection of the prostate (TURP) in patients with large volume benign prostatic hyperplasia (BPH).经尿道前列腺电切术联合耻骨上前列腺切除术治疗大体积良性前列腺增生症的临床应用。
Urologia. 2020 May;87(2):65-69. doi: 10.1177/0391560319834492. Epub 2019 Mar 14.
9
Minimally invasive surgery in the management of benign prostatic hyperplasia.良性前列腺增生症治疗中的微创手术
Minerva Urol Nefrol. 2009 Sep;61(3):269-89.
10
[Endoscopic enucleation of the prostate].[前列腺内镜剜除术]
Urologe A. 2019 Apr;58(4):437-450. doi: 10.1007/s00120-019-0910-9.
引用本文的文献
1
Comparative efficacy and safety of silodosin and tadalafil combination or monotherapy for treating lower urinary tract symptoms due to benign prostatic obstruction: A systematic review and meta-analysis.西洛多辛与他达拉非联合用药或单药治疗良性前列腺梗阻所致下尿路症状的疗效及安全性比较：一项系统评价与荟萃分析
Cent European J Urol. 2025;78(2):165-176. doi: 10.5173/ceju.2024.0219. Epub 2025 May 7.
2
Development of a Drug-Loaded Shape-Memory Polymer Urethral Stent (SMPUS) for Treatment of Prostatic Urethral Obstruction (PUO).用于治疗前列腺尿道梗阻（PUO）的载药形状记忆聚合物尿道支架（SMPUS）的研发
ACS Omega. 2025 Aug 7;10(32):36672-36681. doi: 10.1021/acsomega.5c05903. eCollection 2025 Aug 19.
3
Dehydroepiandrosterone Decline in Aging Males as a Predictor of Erectile Dysfunction and Mood Disorders in Patients With Benign Prostate Hyperplasia Undergoing Dutasteride Treatment.老年男性脱氢表雄酮水平下降作为接受度他雄胺治疗的良性前列腺增生患者勃起功能障碍和情绪障碍的预测指标
Am J Mens Health. 2025 Jul-Aug;19(4):15579883251365091. doi: 10.1177/15579883251365091. Epub 2025 Aug 23.
4
The use of a novel complication reporting system: the comprehensive complication index in thulium laser enucleation of the prostate.一种新型并发症报告系统的应用：前列腺铥激光剜除术中的综合并发症指数
Eur J Med Res. 2025 Aug 19;30(1):770. doi: 10.1186/s40001-025-03052-x.
5
Effects of different doses of ephedrine spinal anesthesia on hemodynamics and adverse reactions in patients undergoing transurethral resection of the prostate.不同剂量麻黄碱脊髓麻醉对经尿道前列腺切除术患者血流动力学及不良反应的影响
BMC Urol. 2025 Jul 31;25(1):186. doi: 10.1186/s12894-025-01880-x.
6
Water vapor thermal therapy for patients with large prostates (≥ 80 mL): initial real-world data from China.大前列腺（≥80毫升）患者的水蒸气热疗法：来自中国的初始真实世界数据。
Int Urol Nephrol. 2025 Jul 14. doi: 10.1007/s11255-025-04667-z.
7
To Rezūm or Not to Rezūm: A Narrative Review of Water Vapor Thermal Therapy for Benign Prostatic Hyperplasia.是否选择Rezūm：良性前列腺增生水蒸气热疗法的叙述性综述
J Clin Med. 2025 Jun 15;14(12):4254. doi: 10.3390/jcm14124254.
8
Integrative Approaches to Prostate Disease Management: Nutrition, Exercise, and Lifestyle Modifications.前列腺疾病管理的综合方法：营养、运动与生活方式调整
Am J Mens Health. 2025 May-Jun;19(3):15579883251344571. doi: 10.1177/15579883251344571. Epub 2025 Jun 23.
9
Empowering patient choice: a systematic review of decision aids for benign prostatic hyperplasia.增强患者选择权：对良性前列腺增生症决策辅助工具的系统评价
BJU Int. 2025 Sep;136(3):359-371. doi: 10.1111/bju.16797. Epub 2025 May 27.
本文引用的文献
1
Impact on Sexual Function of Endoscopic Enucleation Transurethral Resection of the Prostate for Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis.经尿道前列腺腔内剜除术与经尿道前列腺电切术治疗良性前列腺增生所致下尿路症状对性功能影响的系统评价和 Meta 分析。
J Endourol. 2020 Oct;34(10):1064-1074. doi: 10.1089/end.2020.0141. Epub 2020 May 5.
2
Bipolar versus monopolar transurethral resection of the prostate for lower urinary tract symptoms secondary to benign prostatic obstruction.双极与单极经尿道前列腺切除术治疗良性前列腺梗阻继发的下尿路症状
Cochrane Database Syst Rev. 2019 Dec 3;12(12):CD009629. doi: 10.1002/14651858.CD009629.pub4.
3
Efficacy, safety, and tolerability of mirabegron in patients aged ≥65yr with overactive bladder wet: a phase IV, double-blind, randomised, placebo-controlled study (PILLAR).米拉贝隆治疗≥65 岁伴膀胱过度活动症的有效性、安全性和耐受性：一项四期、双盲、随机、安慰剂对照研究（PILLAR）。
Eur Urol. 2020 Feb;77(2):211-220. doi: 10.1016/j.eururo.2019.10.002. Epub 2019 Nov 13.
4
Efficacy and safety of aquablation of the prostate for patients with symptomatic benign prostatic enlargement: a systematic review.经尿道前列腺水（汽）化术治疗症状性良性前列腺增生症的疗效和安全性的系统评价。
World J Urol. 2020 May;38(5):1147-1163. doi: 10.1007/s00345-019-02959-5. Epub 2019 Sep 26.
5
Comparison of photoselective green light laser vaporisation versus traditional transurethral resection for benign prostate hyperplasia: an updated systematic review and meta-analysis of randomised controlled trials and prospective studies.经尿道选择性绿激光汽化术与传统经尿道前列腺切除术治疗良性前列腺增生症的比较：随机对照试验和前瞻性研究的更新系统评价和荟萃分析。
BMJ Open. 2019 Aug 21;9(8):e028855. doi: 10.1136/bmjopen-2018-028855.
6
First- and Second-Generation Temporary Implantable Nitinol Devices As Minimally Invasive Treatments for BPH-Related LUTS: Systematic Review of the Literature.第一代和第二代临时可植入形状记忆合金装置作为治疗 BPH 相关 LUTS 的微创治疗方法：文献系统评价。
Curr Urol Rep. 2019 Jul 5;20(8):47. doi: 10.1007/s11934-019-0912-6.
7
Clinical and Patient-reported Outcome Measures in Men Referred for Consideration of Surgery to Treat Lower Urinary Tract Symptoms: Baseline Results and Diagnostic Findings of the Urodynamics for Prostate Surgery Trial; Randomised Evaluation of Assessment Methods (UPSTREAM).男性下尿路症状手术治疗评估中患者报告结局和临床评估指标：前列腺手术尿动力学研究；评估方法随机评估（UPSTREAM）的基线结果和诊断发现。
Eur Urol Focus. 2019 May;5(3):340-350. doi: 10.1016/j.euf.2019.04.006. Epub 2019 Apr 30.
8
Two-Year Outcomes After Aquablation Compared to TURP: Efficacy and Ejaculatory Improvements Sustained.与 TURP 相比，Aquablation 治疗两年后的结果：疗效和射精改善持续。
Adv Ther. 2019 Jun;36(6):1326-1336. doi: 10.1007/s12325-019-00952-3. Epub 2019 Apr 26.
9
Efficacy and safety of enucleation vs. resection of prostate for treatment of benign prostatic hyperplasia: a meta-analysis of randomized controlled trials.前列腺切除术与前列腺切除术治疗良性前列腺增生的疗效和安全性：随机对照试验的荟萃分析。
Prostate Cancer Prostatic Dis. 2019 Dec;22(4):493-508. doi: 10.1038/s41391-019-0135-4. Epub 2019 Feb 28.
10
Aquablation for benign prostatic hyperplasia in large prostates (80-150 mL): 6-month results from the WATER II trial.水刀消融术治疗大体积前列腺良性前列腺增生（80-150ml）：WATER II 试验 6 个月结果。
BJU Int. 2019 Aug;124(2):321-328. doi: 10.1111/bju.14703. Epub 2019 Mar 29.
Zotero 插件