Jonler M, Riehmann M, Brinkmann R, Bruskewitz R C
Division of Urology, University of Wisconsin, Madison.
Endocrinol Metab Clin North Am. 1994 Dec;23(4):795-807.
Benign prostatic hyperplasia (BPH) is the most common cause of bladder outlet obstruction and voiding symptoms in elderly men. The pathogenesis is not fully determined but a combination of androgens and age are needed for development of BPH. Symptoms of BPH are divided into obstructive and irritative symptoms but large interpersonal variability is found and no specific BPH symptom exists. Treatment modalities include surgery (TURP, TUIP, open prostatectomy, laser ablation, balloon dilatation, hyperthermia and thermotherapy, and urethral stents) and medical therapy. TURP is the gold standard treatment and TUIP is a safe and effective alternative to TURP in patients with smaller prostates. Laser ablation, hyperthermia and thermotherapy, and urethral stents are at the present time under investigation. Balloon dilatation is FDA-approved but not often used because of low efficacy and poor long-term results. Medical treatment includes alpha-blocker or finasteride treatment and is indicated in patients with moderate to severe symptoms of BPH without a strong indication for surgery.
良性前列腺增生（BPH）是老年男性膀胱出口梗阻和排尿症状的最常见原因。其发病机制尚未完全明确，但雄激素和年龄共同作用是BPH发生发展所必需的。BPH的症状分为梗阻性和刺激性症状，但个体差异较大，不存在特定的BPH症状。治疗方式包括手术（经尿道前列腺切除术、经尿道前列腺切开术、开放性前列腺切除术、激光消融、球囊扩张、热疗和温热疗法以及尿道支架置入术）和药物治疗。经尿道前列腺切除术是金标准治疗方法，对于前列腺较小的患者，经尿道前列腺切开术是经尿道前列腺切除术的一种安全有效的替代方法。目前正在对激光消融、热疗和温热疗法以及尿道支架置入术进行研究。球囊扩张术已获美国食品药品监督管理局（FDA）批准，但由于疗效低和长期效果差，不常使用。药物治疗包括α受体阻滞剂或非那雄胺治疗，适用于有中度至重度BPH症状但无强烈手术指征的患者。
