Urology, Memorial Sloan Kettering Cancer Center, New York, New York.
American Urological Association, Linthicum, Maryland.
J Urol. 2024 Jan;211(1):11-19. doi: 10.1097/JU.0000000000003698. Epub 2023 Sep 14.
The purpose of this American Urological Association (AUA) Guideline amendment is to provide a useful reference on the effective evidence-based management of male lower urinary tract symptoms secondary/attributed to BPH (LUTS/BPH).
The Minnesota Evidence Review Team searched Ovid MEDLINE, the Cochrane Library, and the Agency for Healthcare Research and Quality (AHRQ) database to identify studies relevant to the management of BPH. The guideline was updated in 2023 to capture eligible literature published between September 2020 and October 2022. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions.
The BPH amendment resulted in changes to statements/supporting text on combination therapy, photoselective vaporization of the prostate (PVP), water vapor thermal therapy (WVTT), laser enucleation, and prostate artery embolization (PAE). A new statement on temporary implanted prostatic devices (TIPD) was added. In addition, statements on transurethral needle ablation (TUNA) and transurethral microwave thermotherapy (TUMT) were removed and information regarding these legacy technologies was added to the background section. References and the accompanying treatment algorithms were updated to align with the updated text.
This guideline seeks to improve clinicians' ability to evaluate and treat patients with BPH/LUTS based on currently available evidence. Future studies will be essential to further support these statements to improve patient care.
本次美国泌尿外科学会（AUA）指南修订的目的是为 BPH（下尿路症状/良性前列腺增生症，LUTS/BPH）继发/伴发的男性下尿路症状的有效循证管理提供有用的参考。
明尼苏达循证审查小组在 Ovid MEDLINE、考科兰循证医学数据库和美国医疗保健研究与质量局（AHRQ）数据库中搜索了与 BPH 管理相关的研究。该指南于 2023 年更新，以纳入 2020 年 9 月至 2022 年 10 月期间发表的合格文献。当存在足够证据时，证据体被评为 A（高）、B（中）或 C（低），以支持强、中或条件推荐。在缺乏足够证据的情况下，提供了更多的临床原则和专家意见。
BPH 修订导致了关于联合治疗、前列腺选择性光汽化术（PVP）、水蒸汽热疗（WVTT）、激光前列腺剜除术和前列腺动脉栓塞术（PAE）的陈述/支持文本的变化。新增了关于临时植入前列腺装置（TIPD）的新陈述。此外，删除了关于经尿道针状消融术（TUNA）和经尿道微波热疗（TUMT）的陈述，并将这些传统技术的信息添加到背景部分。参考文献和配套的治疗算法已更新，以与更新后的文本保持一致。
本指南旨在提高临床医生根据现有证据评估和治疗 BPH/LUTS 患者的能力。未来的研究对于进一步支持这些陈述以改善患者护理至关重要。
