良性前列腺增生:快速证据审查
Michael J Arnold1, Andrew Gaillardetz2, Jafar Ohiokpehai2
1Uniformed Services University of the Health Sciences, Bethesda, Maryland.
American family physician
|June 16, 2023
概括
良性前列腺增生症 (BPH) 在许多男性中引起下泌尿道症状. 有效的管理包括改变生活方式,药物,如α阻断剂,和潜在的5-α减少酶抑制剂更大的前列腺.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 男人的健康 男人的健康
- 药理学 药理学是指药理学的学科.
背景情况:
- 由于良性前列腺增生 (BPH) 的下泌尿道症状 (LUTS) 影响了25%的美国男性,显著的症状负担减少了一半.
- LUTS的危险因素包括久坐不动的生活方式,高血压和糖尿病.
- 准确的前列腺评估对于有效的BPH管理至关重要.
研究的目的:
- 审查BPH中LUTS的当前诊断和治疗策略.
- 突出患者报告结果和自我管理的作用.
- 讨论各种医疗和手术干预措施的有效性.
主要方法:
- 对前列腺评估诊断工具的文献综述.
- 对自我管理技术和草药疗法的证据分析.
- 对药理疗法的评估,包括α阻断剂,PDE-5抑制剂和5α减小酶抑制剂.
- 对耐火性BPH的手术选择的审查.
主要成果:
- 超直肠超声波是前列腺大小的首选,特别是在5α减小酶抑制剂治疗或手术前.
- 国际前列腺症状评分 (IPSS) 是症状跟踪的标准.
- 自主管理,Pygeum africanum和β-sitosterol显示出潜在的症状改善;看到了palmetto是无效的.
- 阿尔法阻断剂提供快速缓解;5-阿尔法减少酶抑制剂在长期使用时对较大的前列腺 (>30毫升) 有益,理想情况下与阿尔法阻断剂一起使用.
- 很少需要手术,可用的是不那么侵入性的选择.
结论:
- 综合评估和量身定制的治疗计划对于在BPH中管理LUTS至关重要.
- 改变生活方式,适当的药物治疗和癌症查的共享决策的结合优化了患者的结果.
- 对于BPH来说,越来越多地喜欢不那么侵入性的治疗方法,而不是传统的手术.
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