Mantica Guglielmo, Ambrosini Francesca, Drocchi Giovanni, Zubko Zlata, Lo Monaco Lorenzo, Cafarelli Angelo, Calarco Alessandro, Colombo Renzo, De Cobelli Ottavio, De Marco Ferdinando, Ferrari Giovanni, Ludovico Giuseppe, Pecoraro Stefano, Tuzzolo Domenico, Terrone Carlo, Leonardi Rosario
Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genoa; IRCCS Ospedale Policlinico San Martino, Genoa.
IRCCS Ospedale Policlinico San Martino, Genoa.
Arch Ital Urol Androl. 2024 Dec 18;96(4):13098. doi: 10.4081/aiua.2024.13098.
Benign prostatic hyperplasia (BPH) is a common urological disease that is strongly associated with the aging process and can lead to lower urinary tract symptoms (LUTS). LUTS due to BPH can significantly affect the quality of life of many patients. Among the treatments available for BPH to improve symptoms and functional outcomes, drug therapy and surgical therapy are the options of choice. However, for most patients with symptomatic BPH, medical management remains the cornerstone of treatment. Pharmacologic interventions are often preferred as a first approach, being less invasive compared to surgery. Although the medical treatment of BPH is currently defined by the algorithms of international guidelines, the need for a more personalized approach is increasingly recognized given the wide and heterogeneous range of therapeutic options available.
A review of medical therapy for BPH was conducted using relevant articles in PubMed, Scopus, and the Cochrane Central Register of Controlled Trials. In this review, all drug treatments currently available on the international market whose efficacy is scientifically proven are reviewed and described (phytotherapy, alpha-blockers, muscarinic receptor antagonists, 5-alpha-reductase inhibitors, combination therapies, etc.).
A total of 17 randomized clinical trials were selected for review. Further, 75 studies were included for analysis and discussion.
As the treatment landscape continues to evolve, tailoring therapy to individual patient needs and preferences is likely to become increasingly important to ensure that treatment strategies are both effective and meet patient expectations.
良性前列腺增生（BPH）是一种常见的泌尿系统疾病，与衰老过程密切相关，可导致下尿路症状（LUTS）。BPH所致的LUTS可显著影响许多患者的生活质量。在可用于改善BPH症状和功能结局的治疗方法中，药物治疗和手术治疗是首选方案。然而，对于大多数有症状的BPH患者，药物治疗仍然是治疗的基石。药物干预通常作为首选方法，与手术相比侵入性较小。尽管目前BPH的药物治疗是由国际指南的算法定义的，但鉴于可用的治疗选择广泛且多样，越来越需要采用更个性化的方法。
使用PubMed、Scopus和Cochrane对照试验中央注册库中的相关文章对BPH的药物治疗进行综述。在本综述中，对目前国际市场上所有疗效经科学验证的药物治疗进行了综述和描述（植物疗法、α受体阻滞剂、毒蕈碱受体拮抗剂、5α还原酶抑制剂、联合疗法等）。
共选择了17项随机临床试验进行综述。此外，纳入了75项研究进行分析和讨论。
随着治疗格局不断演变，根据个体患者的需求和偏好调整治疗方案对于确保治疗策略既有效又能满足患者期望可能变得越来越重要。
