|
|
良性前列腺增生与下尿路症状
|
Abstract:
良性前列腺增生(Benign Prostatic Hyperplasia, BPH)是影响男性的最常见的疾病之一。BPH可导致患者的许多症状，通常称为下尿路症状(Lower Urinary Tract Symptoms, LUTS)。一些危险因素增加，如代谢疾病和肥胖，导致BPH发病率增加。在过去几十年中，发病率的增加带来了多种治疗方式。目前的治疗方法首先可分为内科或外科干预。目前来说，经尿道前列腺切除术(TURP)仍然是主要的治疗方式之一。但是，如果有另外更好的选择，许多患者会选择避免手术。药物治疗是一种有效的替代方法，然而，新的研究表明，药物治疗可能会有比以前认识到的更多的副作用。一些微创手术治疗(MIST)已经出现，提供了有效和持久的结果，同时在很大程度上使男性免受更具侵入性的手术所带来的副作用。BPH伴LUTS的治疗有一系列药物、程序和手术选择，本文主要叙述目前良性前列腺增生(BPH)患者下尿路症状(LUTS)的相关治疗方法以及未来发展方向。
Benign prostatic hyperplasia (BPH) is one of the most common diseases affecting men. BPH can cause many symptoms of patients, commonly referred to as lower urinary tract symptoms (LUTS). Some risk factors, such as metabolic diseases and obesity, increase the incidence rate of BPH. In the past decades, the increase in incidence rate has led to a variety of treatments. The current treat-ment methods can be divided into medical or surgical intervention. At present, transurethral pros-tatectomy (TURP) is still one of the main treatment methods. However, if there is another better choice, many patients will choose to avoid surgery. Drug treatment is an effective alternative. How-ever, new research shows that drug treatment may have more side effects than previously recog-nized. Some minimally invasive surgical treatments (MIST) have emerged, providing effective and lasting results, while largely protecting men from the side effects of more invasive surgery. There are a series of drugs, procedures and surgical options for the treatment of BPH with LUTS. This arti-cle mainly describes the current treatment methods and future development direction of lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH).
| [1] | Mcneal, J.E. (1981) The Zonal Anatomy of the Prostate. The Prostate, 2, 35-49.
https://doi.org/10.1002/pros.2990020105 |
| [2] | Berry, S.J., Coffey, D.S., Walsh, P.C. and Ewing, L.L. (1984) The Development of Human Benign Prostatic Hyperplasia with Age. The Journal of Urology, 132, 474-479. https://doi.org/10.1016/S0022-5347(17)49698-4 |
| [3] | Wei, J.T., Calhoun, E. and Jacobsen, S.J. (2005) Urologic Diseases in America Project: Benign Prostatic Hyperplasia. The Journal of Urology, 173, 1256-1261. https://doi.org/10.1097/01.ju.0000155709.37840.fe |
| [4] | Parsons, J.K. (2010) Benign Prostatic Hyperplasia and Male Lower Urinary Tract Symptoms: Epidemiology and Risk Factors. Current Bladder Dysfunction Reports, 5, 212-218. https://doi.org/10.1007/s11884-010-0067-2 |
| [5] | Litman, H.J. and McKinlay, J.B. (2007) The Future Magnitude of Urological Symptoms in the USA: Projections Using the Boston Area Community Health Survey. BJU International, 100, 820-825.
https://doi.org/10.1111/j.1464-410X.2007.07018.x |
| [6] | Lee, A.J., Garraway, W.M., Simpson, R.J., Fisher, W. and King, D. (1998) The Natural History of Untreated Lower Urinary Tract Symptoms in Middle-Aged and Elderly Men over a Period of Five Years. European Urology, 34, 325-332. https://doi.org/10.1159/000019749 |
| [7] | Vos, T., Flaxman, A.D., Naghavi, M., et al. (2012) Years Lived with Disability (YLDs) for 1160 Sequelae of 289 Diseases and Injuries 1990-2010: A Systematic Analysis for the Global Burden of Disease Study 2010. Lancet, 380, 2163-2196. https://doi.org/10.1016/S0140-6736(12)61729-2 |
| [8] | Egan, K.B. (2016) The Epidemiology of Benign Prostatic Hyperplasia Associated with Lower Urinary Tract Symptoms: Prevalence and Incident Rates. The Urologic Clinics of North America, 43, 289-297.
https://doi.org/10.1016/j.ucl.2016.04.001 |
| [9] | Patel, N.D. and Parsons, J.K. (2014) Epidemiology and Etiology of Benign Prostatic Hyperplasia and Bladder Outlet Obstruction. Indian Journal of Urology, 30, 170-176. https://doi.org/10.4103/0970-1591.126900 |
| [10] | Lee, R.K., Chung, D., Chughtai, B., Te, A.E. and Kaplan, S.A. (2012) Central Obesity as Measured by Waist Circumference is Predictive of Severity of Lower Urinary Tract Symptoms. BJU International, 110, 540-545.
https://doi.org/10.1111/j.1464-410X.2011.10819.x |
| [11] | Parikesit, D., Mochtar, C.A., Umbas, R. and Hamid, A.R.A.H. (2016) The Impact of Obesity towards Prostate Diseases. Prostate International, 4, 1-6. https://doi.org/10.1016/j.prnil.2015.08.001 |
| [12] | Nickel, J.C. (2008) Inflammation and Benign Prostatic Hyperplasia. The Urologic Clinics of North America, 35, 109-115.
https://doi.org/10.1016/j.ucl.2007.09.012 |
| [13] | Abdul-Muhsin, H.M., Jakob, N.J., McLemore, R.M., McAdams, S.B. and Humphreys, M.R. (2016) Infectious Complications Associated with the Use of Temporary Prostatic Urethral Stents in Patients with Benign Prostatic Hyperplasia. The Canadian Journal of Urology, 23, 8465-8470. https://pubmed.ncbi.nlm.nih.gov/27705732/ |
| [14] | Rand, H.W. (1895) A Contribution to the Surgery of the Hyper-trophied Prostate. Annals of Surgery, 22, 217-225.
https://doi.org/10.1097/00000658-189507000-00020 |
| [15] | Lee, C., Kozlowski, J.M. and Grayhack, J.T. (1997) In-trinsic and Extrinsic Factors Controlling Benign Prostatic Growth. The Prostate, 31, 131-138.
https://doi.org/10.1002/(SICI)1097-0045(19970501)31:2<131::AID-PROS9>3.0.CO;2-Q |
| [16] | Bruchovsky, N., Lesser, B., Van Doorn, E. and Craven, S. (1976) Hormonal Effects on Cell Proliferation in Rat Prostate. Vitamins & Hormones, 33, 61-102. https://doi.org/10.1016/S0083-6729(08)60951-6 |
| [17] | Wilson, J.D. (1980) The Pathogene-sis of Benign Prostatic Hyperplasia. The American Journal of Medicine, 68, 745-756. https://doi.org/10.1016/0002-9343(80)90267-3 |
| [18] | Shi, X., Peng, Y., Du, X., et al. (2017) Estradiol Promotes Epithelial-to-Mesenchymal Transition in Human Benign Prostatic Epithelial Cells. The Prostate, 77, 1424-1437. https://doi.org/10.1002/pros.23404 |
| [19] | Alonso-Magdalena, P., Br？ssner, C., Reiner, A., et al. (2009) A Role for Epithelial-Mesenchymal Transition in the Etiology of Benign Prostatic Hyperplasia. Proceedings of the National Academy of Sciences of the United States of America, 106, 2859-2863. https://doi.org/10.1073/pnas.0812666106 |
| [20] | De Nunzio, C., Roehrborn, C.G., Andersson, K.-E. and McVary, K.T. (2017) Erectile Dysfunction and Lower Urinary Tract Symptoms. European Urology Focus, 3, 352-363. https://doi.org/10.1016/j.euf.2017.11.004 |
| [21] | Gacci, M., Eard-ley, I., Giuliano, F., et al. (2011) Critical Analysis of the Relationship between Sexual Dysfunctions and Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia. European Urology, 60, 809-825.
https://doi.org/10.1016/j.eururo.2011.06.037 |
| [22] | Yassin, A., Saad, F., Hoesl, C.E., et al. (2006) Al-pha-Adrenoceptors Are a Common Denominator in the Pathophysiology of Erectile Function and BPH/LUTS—Implications for Clinical Practice. Andrologia, 38, 1-12.
https://doi.org/10.1111/j.1439-0272.2006.00709.x |
| [23] | Vuichoud, C. and Loughlin, K.R. (2015) Benign Prostatic Hyperplasia: Epidemiology, Economics and Evaluation. The Canadian Journal of Urology, 22, 1-6. |
| [24] | Mirone, V., Sessa, A., Giuliano, F., et al. (2011) Current Benign Prostatic Hyperplasia Treatment: Impact on Sexual Function and Management of Related Sexual Adverse Events. International Journal of Clinical Practice, 65, 1005-1013.
https://doi.org/10.1111/j.1742-1241.2011.02731.x |
| [25] | Roehrborn, C. G., Barkin, J., Gange, S. N., et al. (2017) Five Year Results of the Prospective Randomized Controlled Prostatic Urethral L.I.F.T. Study. The Canadian Journal of Urology, 24, 8802-8813. |
| [26] | McNicholas, T.A., Woo, H.H., Chin, P.T., et al. (2013) Minimally Invasive Prostatic Urethral Lift: Surgical Technique and Multinational Experience. European Urology, 64, 292-299. https://doi.org/10.1016/j.eururo.2013.01.008 |
| [27] | S？nksen, J., Barber, N.J., Speakman, M.J., et al. (2015) Pro-spective, Randomized, Multinational Study of Prostatic Urethral Lift Versus Transurethral Resection of the Prostate: 12-Month Results from the BPH6 Study. European Urology, 68, 643-652. https://doi.org/10.1016/j.eururo.2015.04.024 |
| [28] | Shore, N. (2015) A Review of the Prostatic Urethral Lift for Lower Urinary Tract Symptoms: Symptom Relief, Flow Improvement, and Preservation of Sexual Function in Men with Benign Prostatic Hyperplasia. Current Bladder Dysfunction Reports, 10, 186-192. https://doi.org/10.1007/s11884-015-0296-5 |
| [29] | McVary, K.T., Gange, S.N., Gittelman, M.C., et al. (2016) Mini-mally Invasive Prostate Convective Water Vapor Energy Ablation: A Multicenter, Randomized, Controlled Study for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia. The Journal of Urology, 195, 1529-1538.
https://doi.org/10.1016/j.juro.2015.10.181 |
| [30] | McVary, K.T., Rogers, T. and Roehrborn, C.G. (2019) Rezūm Water Vapor Thermal Therapy for Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia: 4-Year Results from Randomized Controlled Study. Urology, 126, 171-179. https://doi.org/10.1016/j.urology.2018.12.041 |
| [31] | Gilling, P., Reuther, R., Kahokehr, A. and Fraundorfer, M. (2016) Aquablation—Image-Guided Robot-Assisted Waterjet Ablation of the Prostate: Initial Clinical Experience. BJU International, 117, 923-929.
https://doi.org/10.1111/bju.13358 |
| [32] | Gilling, P., Barber, N., Bidair, M., et al. (2018) WATER: A Double-Blind, Randomized, Controlled Trial of Aquablation？ vs Transurethral Resection of the Prostate in Benign Prostatic Hyperplas-ia. The Journal of Urology, 199, 1252-1261. https://doi.org/10.1016/j.juro.2017.12.065 |
| [33] | Gilling, P., Barber, N., Bidair, M., et al. (2019) Two-Year Outcomes after Aquablation Compared to TURP: Efficacy and Ejaculatory Improve-ments Sustained. Advances in Therapy, 36, 1326-1336.
https://doi.org/10.1007/s12325-019-00952-3 |
| [34] | Abt, D., Hechelhammer, L., Müllhaupt, G., Markart, S., et al. (2018) Comparison of Prostatic Artery Embolisation (PAE) versus Transurethral Resection of the Prostate (TURP) for Benign Prostatic Hyperplasia: Randomised, Open Label, Non-Inferiority Trial. BMJ, 361, Article No. k2338. https://doi.org/10.1136/bmj.k2338 |
| [35] | Pisco, J.M., Bilhim, T., Pinheiro, L.C., et al. (2016) Medium- and Long-Term Outcome of Prostate Artery Embolization for Patients with Benign Prostatic Hyperplasia: Results in 630 Pa-tients. Journal of Vascular and Interventional Radiology, 27, 1115-1122. https://doi.org/10.1016/j.jvir.2016.04.001 |
| [36] | Bortnick, E., Brown, C., Simma-Chiang, V. and Kaplan, S.A. (2020) Modern Best Practice in the Management of Benign Prostatic Hyperplasia in the Elderly. Therapeutic Advances in Urol-ogy, 12, Article ID: 1756287220929486.
https://doi.org/10.1177/1756287220929486 |
| [37] | Huang, S.W., Tsai, C.Y., Tseng, C.S., et al. (2019) Comparative Efficacy and Safety of New Surgical Treatments for Benign Prostatic Hyperplasia: Systematic Review and Network Me-ta-Analysis. BMJ, 367, Article No. l5919.
https://doi.org/10.1136/bmj.l5919 |
| [38] | Magistro, G., Chapple, C.R., Elhilali, M., et al. (2017) Emerging Minimally Invasive Treatment Options for Male Lower Urinary Tract Symptoms. European Urology, 72, 986-997. https://doi.org/10.1016/j.eururo.2017.07.005 |
