12/28/2023 0 Comments App icon generator by paolo biaginiThe following databases were searched: Medline, Embase, CRD database, NHS Economic Evaluation Database, Health Technology Assessment Database. The commission defined the scope of the guidelines, the clinical questions, other relevant aspects (populations, interventions, outcomes, acceptable study designs), and literature search strategies. Lastly, the final report was prepared according to the recommendations of the Conference on Guidelines Standardization. The quality of evidence and strength of recommendations was determined according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework. The literature research was conducted in accordance with recommendations from the Centre for Reviews and Dissemination, University of York, UK. ![]() Only key studies are included, with the full list provided in the online version. This article provides a summary of the updated guidelines. Consequently, a new update of the guidelines has become necessary. Since then, a number of new drugs or classes of drugs have emerged for the treatment of LUTS related to BPH, new data have emerged on medical therapy (monotherapies and combination therapies), new surgical techniques have come into practice, and our understanding of disease pathogenesis has increased. The Italian Association of Urologists () guidelines were previously updated in 2006. LUTS/BPH are also associated with considerable healthcare costs, and the economic impact is likely to increase in line with the aging of populations. BPH may be associated with bothersome lower urinary tract symptoms (LUTS), which can negatively impact quality of life (QoL). While the recommendations included in these guidelines are evidence based, clinical decisions should also be informed by patients’ clinical and physical circumstances, as well as patients’ preferences and actions.īenign prostatic hyperplasia (BPH) is a complex pathological disease that is progressive in a large proportion of older men. ![]() Other differences include the warning of potential worsening of cognitive disturbances with use of anticholinergics in older patients, the distinction between Serenoa repens preparations (according to the method of extraction), and the clearly defined threshold of prostate size for performing open surgery (>80 g). ![]() For example, combination therapy with a 5α-reductase inhibitor plus α blocker is now the recommended option for the treatment of patients at risk of BPH progression. Several differences in clinical recommendations have emerged. A threshold for intervention was therefore based on the IPSS Q8, with intervention recommended for patients with a score of at least 4. Decisions on therapeutic intervention should be based on the impact of symptoms on quality of life (QoL) rather than the severity of symptoms (International Prostate Symptom Score (IPSS) score).
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