Evidence-Based Treatment for a Newly Diagnosed Prostatic Hyperplasia in an Elderly Patient_Chinese Journal of Evidence-Based Medicine

Authors：

CHEN Hualei ,  LI Shiwen , WANG Xinghuan , ZHENG Xinmin , DING Xiegang

Department of Urology, Zhongnan Hospital, Wuhan University, Wuhan 430071, China;

Corresponding author：

LI Shiwen, Email: chenhualei888@yahoo.com.cn

Keywords：

Prostatic hyperplasia; Elderly patient; Evidence-based treatment; Randomized controlled trial

DOI：

10.7507/1672-2531.20090163

Video：

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Objective 　Evidence-based medicine was used to make an individualized treatment plan for newly diagnosed prostatic hyperplasia in an elderly patient.
Methods 　After clinical problems were discovered, evidence was collected from CBM, CNKI, The Cochrane Library, PubMed, EMBASE, ScienceDirect, Springer, and ProQuest databases according to our predefined search strategy. The search was done through 2008. The internal and external validity of the evidence was assessed. The evidence, combined with the patient value, was applied to the patient.
Results 　A total of 39 systematic reviews involving 137 randomized controlled trials were identified. A rational treatment plan was made upon a critical evaluation of the data. After one year follow-up, the treatment protocol was proven correct.
Conclusion 　The treatment efficacy in newly diagnosed prostatic hyperplasia in the elderly has been improved by determining an individualized treatment protocol according to evidence-based methods.

Citation： CHEN Hualei,LI Shiwen,WANG Xinghuan,ZHENG Xinmin,DING Xiegang. Evidence-Based Treatment for a Newly Diagnosed Prostatic Hyperplasia in an Elderly Patient. Chinese Journal of Evidence-Based Medicine, 2009, 09(8): 924-928. doi: 10.7507/1672-2531.20090163 Copy

1.	马志方, 王东文, 马腾骧, 等. 多沙唑嗪控释片和坦索罗辛治疗前列腺增生症的对照研究. 天津医学, 2005, 33(1): 22-24.
2.	MacDonald R, Timothy J. Alfuzosin for treatment of lower urinary tract symptoms compatible with benign prostatic hyperplasia: a systematic review of efficacy and adverse effects. Urology, 2005, 66: 780-788.
3.	Ng CF, Wong A, Cheng CW, et al. Effect of vardenafil on blood pressure profile of patients with erectile dysfunction concomitantly treated with doxazosin gastrointestinal therapeutic system for benign prostatic hyperplasia. J Urol, 2008, 180(3): 1042-1046.
4.	Rosen R, Seftel A, Roehrborn CG. Effects of alfuzosin 10 mg once daily on sexual function in men treated for symptomatic benign prostatic hyperplasia. Int J Impot Res, 2007, 19(5): 480-485.
5.	袁穗榕, 胡建波. 盐酸坦索罗辛治疗前列腺增生症的疗效及安全性的临床分析. 海峡药学, 2005, 17(2): 98-100.
6.	华立新, 吴宏飞, 眭元庚, 等. 哈乐在良性前列腺增生伴急性尿潴留中的应用. 中华男科学, 2003, 9(7): 510-511.
7.	Prieto L, Romero J, López C, et al. Efficacy of doxazosin in the treatment of acute urinary retention due to benign prostate hyperplasia. Urol Int, 2008, 81(1): 66-71.
8.	任宇, 李宁宁, 叶璐, 等. 坦索罗辛和特拉唑嗪治疗BPH的系统评价. Journal of Clinical Urology, 2006, 21(9): 692-697.
9.	RBLik Sprava, Roehrborn CG, et al. The longtermeffect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. Nurullaev, 2004, 3(1): 101-103.
10.	薛兆英, 韩文科, 金杰, 等. 爱普列特治疗良性前列腺增生II期临床研究. 中国临床药理学杂志, 2000, 16(6): 432-435.
11.	Boyle P, Gould AL, Roehrborn CG, et al. Prostate volume predicts outcome of benign prostate hyperplasia with finasteride:meta-analysis of randomized clinical trials. Urology, 1996, 48(3): 398-405.
12.	Lam JS, Romas NA, Lowe FC. Long-term treatment with finasteride in men with symptomatic benign prostatic hyperplasia: 10-year follow-up. Urology, 2003, 61(2): 354-358.
13.	Kaplan SA, Roehrborn CG, McConnell JD, et al. Long-term treatment with finasteride results in a clinically significant reduction in total prostate volume compared to placebo over the full range of baseline prostate sizes in men enrolled in the MTOPS trial. J Urol, 2008, 180(3): 811-812.
14.	Roehrborn CG, McConnell JD, Lieber M, et al. Serum prostate-specific antigen concentration is a powerful predictorof acute urinary retention and need for surgery in men with clinical benign prostatic hyperplasia. PLESS StudyGroup. Urology, 1999, 53: 473-480.
15.	Roehrborn CG. The potential of serum prostate-specific antigen as a predictor of clinical response in patients with lower urinary tract symptoms and benign prostatic hyperplasia. BJU Int, 2004, 93: 21-26.
16.	Crawford ED, Wilson SS, McConnell JD, et al. Baseline factors as predictors of clinical progression of benign prostatic hyperplasia in men treated with placebo. J Urol, 2006, 175: 1422-1427.
17.	黄遂斌, 魏继刚, 章传华, 等. 经尿道汽化电切术联合微波治疗前列腺增生症. 中国康复杂志, 2007, 22(5): 352.
18.	Lourenco T, Pickard R, Vale L, et al. Minimally invasive treatments for benign prostatic enlargement: systematic review of randomised controlled trials. BMJ, 2008, 337-1662.
19.	尧凯, 王祥慧, 杨罗艳. 非那甾安与坦索罗辛治疗良性前列腺增生症疗效对比. 中国男科学杂志, 2006, 20(6): 38-40.
20.	MacDonald R, Wilt TJ, Howe RW, et al. Doxazosin for treating lower urinary tract symptoms compatible with benign prostatic obstruction: a systematic review of efficacy and adverse effects. BJU Int., 2004, 94(9): 1263-1270 .
21.	唐正严, 彭克亮, 丁见, 等. 保列治与哈乐治疗前列腺增生的I临床疗效观察. 中南大学学报 (医学版), 2005, 30(6): 708-710.
22.	叶璐, 任宇, 李懿, 等. 特拉唑嗪、坦洛新及非那雄胺治疗良性前列腺增生症的安全性评价. 药物不良反应志, 2005, 6: 411-417.
23.	熊鹰, 叶璐, 任宇, 等. 特拉唑嗪、非那司提和坦素罗辛治疗良性前列腺增生症的有效性评价.中国循证医学杂志, 2005, 5(6): 448-454转481.
24.	Kaplan SA, McConnell JD, Roehrborn CG, et al. Combination therapy with doxazosin and finasteride for benign prostatic hyperplasia in patients with lower urinary tract symptoms and a baseline total prostate volume of 25ml or greater. J Urol, 2006, 175: 217-221.
25.	McConnell JD, Roehrborn CG, Bautista OM, et al. The longterm effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med, 2003, 349(25): 2387-2398.
26.	Marberger M. The MTOPS Study: New Findings, New Insights, and Clinical Implications for the Management of BPH. European Urology Supplements, 2006, 5: 628-633.

1. 马志方, 王东文, 马腾骧, 等. 多沙唑嗪控释片和坦索罗辛治疗前列腺增生症的对照研究. 天津医学, 2005, 33(1): 22-24.
2. MacDonald R, Timothy J. Alfuzosin for treatment of lower urinary tract symptoms compatible with benign prostatic hyperplasia: a systematic review of efficacy and adverse effects. Urology, 2005, 66: 780-788.
3. Ng CF, Wong A, Cheng CW, et al. Effect of vardenafil on blood pressure profile of patients with erectile dysfunction concomitantly treated with doxazosin gastrointestinal therapeutic system for benign prostatic hyperplasia. J Urol, 2008, 180(3): 1042-1046.
4. Rosen R, Seftel A, Roehrborn CG. Effects of alfuzosin 10 mg once daily on sexual function in men treated for symptomatic benign prostatic hyperplasia. Int J Impot Res, 2007, 19(5): 480-485.
5. 袁穗榕, 胡建波. 盐酸坦索罗辛治疗前列腺增生症的疗效及安全性的临床分析. 海峡药学, 2005, 17(2): 98-100.
6. 华立新, 吴宏飞, 眭元庚, 等. 哈乐在良性前列腺增生伴急性尿潴留中的应用. 中华男科学, 2003, 9(7): 510-511.
7. Prieto L, Romero J, López C, et al. Efficacy of doxazosin in the treatment of acute urinary retention due to benign prostate hyperplasia. Urol Int, 2008, 81(1): 66-71.
8. 任宇, 李宁宁, 叶璐, 等. 坦索罗辛和特拉唑嗪治疗BPH的系统评价. Journal of Clinical Urology, 2006, 21(9): 692-697.
9. RBLik Sprava, Roehrborn CG, et al. The longtermeffect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. Nurullaev, 2004, 3(1): 101-103.
10. 薛兆英, 韩文科, 金杰, 等. 爱普列特治疗良性前列腺增生II期临床研究. 中国临床药理学杂志, 2000, 16(6): 432-435.
11. Boyle P, Gould AL, Roehrborn CG, et al. Prostate volume predicts outcome of benign prostate hyperplasia with finasteride:meta-analysis of randomized clinical trials. Urology, 1996, 48(3): 398-405.
12. Lam JS, Romas NA, Lowe FC. Long-term treatment with finasteride in men with symptomatic benign prostatic hyperplasia: 10-year follow-up. Urology, 2003, 61(2): 354-358.
13. Kaplan SA, Roehrborn CG, McConnell JD, et al. Long-term treatment with finasteride results in a clinically significant reduction in total prostate volume compared to placebo over the full range of baseline prostate sizes in men enrolled in the MTOPS trial. J Urol, 2008, 180(3): 811-812.
14. Roehrborn CG, McConnell JD, Lieber M, et al. Serum prostate-specific antigen concentration is a powerful predictorof acute urinary retention and need for surgery in men with clinical benign prostatic hyperplasia. PLESS StudyGroup. Urology, 1999, 53: 473-480.
15. Roehrborn CG. The potential of serum prostate-specific antigen as a predictor of clinical response in patients with lower urinary tract symptoms and benign prostatic hyperplasia. BJU Int, 2004, 93: 21-26.
16. Crawford ED, Wilson SS, McConnell JD, et al. Baseline factors as predictors of clinical progression of benign prostatic hyperplasia in men treated with placebo. J Urol, 2006, 175: 1422-1427.
17. 黄遂斌, 魏继刚, 章传华, 等. 经尿道汽化电切术联合微波治疗前列腺增生症. 中国康复杂志, 2007, 22(5): 352.
18. Lourenco T, Pickard R, Vale L, et al. Minimally invasive treatments for benign prostatic enlargement: systematic review of randomised controlled trials. BMJ, 2008, 337-1662.
19. 尧凯, 王祥慧, 杨罗艳. 非那甾安与坦索罗辛治疗良性前列腺增生症疗效对比. 中国男科学杂志, 2006, 20(6): 38-40.
20. MacDonald R, Wilt TJ, Howe RW, et al. Doxazosin for treating lower urinary tract symptoms compatible with benign prostatic obstruction: a systematic review of efficacy and adverse effects. BJU Int., 2004, 94(9): 1263-1270 .
21. 唐正严, 彭克亮, 丁见, 等. 保列治与哈乐治疗前列腺增生的I临床疗效观察. 中南大学学报 (医学版), 2005, 30(6): 708-710.
22. 叶璐, 任宇, 李懿, 等. 特拉唑嗪、坦洛新及非那雄胺治疗良性前列腺增生症的安全性评价. 药物不良反应志, 2005, 6: 411-417.
23. 熊鹰, 叶璐, 任宇, 等. 特拉唑嗪、非那司提和坦素罗辛治疗良性前列腺增生症的有效性评价.中国循证医学杂志, 2005, 5(6): 448-454转481.
24. Kaplan SA, McConnell JD, Roehrborn CG, et al. Combination therapy with doxazosin and finasteride for benign prostatic hyperplasia in patients with lower urinary tract symptoms and a baseline total prostate volume of 25ml or greater. J Urol, 2006, 175: 217-221.
25. McConnell JD, Roehrborn CG, Bautista OM, et al. The longterm effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med, 2003, 349(25): 2387-2398.
26. Marberger M. The MTOPS Study: New Findings, New Insights, and Clinical Implications for the Management of BPH. European Urology Supplements, 2006, 5: 628-633.

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