Document Detail


Update on AUA guideline on the management of benign prostatic hyperplasia.
MedLine Citation:
PMID:  21420124     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To revise the 2003 version of the American Urological Association's (AUA) Guideline on the management of benign prostatic hyperplasia (BPH).
MATERIALS AND METHODS: From MEDLINE® searches of English language publications (January 1999 through February 2008) using relevant MeSH terms, articles concerning the management of the index patient, a male ≥45 years of age who is consulting a healthcare provider for lower urinary tract symptoms (LUTS) were identified. Qualitative analysis of the evidence was performed. Selected studies were stratified by design, comparator, follow-up interval, and intensity of intervention, and meta-analyses (quantitative synthesis) of outcomes of randomized controlled trials were planned. Guideline statements were drafted by an appointed expert Panel based on the evidence.
RESULTS: The studies varied as to patient selection; randomization; blinding mechanism; run-in periods; patient demographics, comorbidities, prostate characteristics and symptoms; drug doses; other intervention characteristics; comparators; rigor and intervals of follow-up; trial duration and timing; suspected lack of applicability to current US practice; and techniques of outcomes measurement. These variations affected the quality of the evidence reviewed making formal meta-analysis impractical or futile. Instead, the Panel and extractors reviewed the data in a systematic fashion and without statistical rigor. Diagnosis and treatment algorithms were adopted from the 2005 International Consultation of Urologic Diseases. Guideline statements concerning pharmacotherapies, watchful waiting, surgical options and minimally invasive procedures were either updated or newly drafted, peer reviewed and approved by AUA Board of Directors.
CONCLUSIONS: New pharmacotherapies and technologies have emerged which have impacted treatment algorithms. The management of LUTS/BPH continues to evolve.
Authors:
Kevin T McVary; Claus G Roehrborn; Andrew L Avins; Michael J Barry; Reginald C Bruskewitz; Robert F Donnell; Harris E Foster; Chris M Gonzalez; Steven A Kaplan; David F Penson; James C Ulchaker; John T Wei
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Publication Detail:
Type:  Journal Article     Date:  2011-03-21
Journal Detail:
Title:  The Journal of urology     Volume:  185     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-12     Completed Date:  2011-06-28     Revised Date:  2012-01-20    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1793-803     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
American Urological Association Education and Research, Inc., Linthicum Maryland, USA. k-mcvary@northwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Humans
Male
Practice Guidelines as Topic*
Prostatic Hyperplasia / therapy*
United States
Comments/Corrections
Comment In:
J Urol. 2012 Jan;187(1):358-9; author reply 359   [PMID:  22119362 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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