2019 Guidelines for the Management of Benign Prostatic Hyperplasia

Date:2020-02-06 click:0

Benign prostatic hyperplasia (BPH) is defined as the proliferation of glands and stromal tissue in the transition zone of the prostate. It can cause bladder outlet obstruction and then lower urinary tract symptoms (LUTS). The prevalence of BPH increases with age. In men over 70 years of age, more than 70% are affected by BPH and a quarter have moderate-to-severe LUTS.
BPH and its associated LUTS (BPH-LUTS) are significant problems affecting the health of millions of men.The International Prostate Symptom Score (IPSS) and the Quality of Life (QOL) are two commonly used measures to evaluate the treatment effect. If a 3-point change in IPSS occurs, this is significant for patients with LUTS. If the IPSS is reduced by 30%, this therapeutic measure can be considered clinically effective.
Patients with BPH who cannot tolerate or have got fail medical therapy require relatively invasive therapy. Transurethral resection of the prostate (TURP) has long been the gold standard for the treatment of 80 to 100 cm3 of prostate. It can improve IPSS by 15 to 16 points and significantly improve urinary flow rate. However, the associated complications are noteworthy, such as ejaculatory dysfunction, erectile dysfunction, and urethral stricture.
Open prostatectomy (OP) has been the gold standard for prostates > 100 cm3. It improves IPSS by 13 to 18 points and significantly improves objective problems, but requires a longer postoperative recovery period. Postoperative complications are more common in OP than in TURP.
Currently, various minimally invasive surgical techniques (MIST) are gradually developed. They both do so by destroying or moving the prostate tissue that initiates obstruction. MIST was associated with lower complication rates compare to TURP and OP, but poor IPSS improvement and higher rates of repeated surgery.
Prostatic artery embolization (PAE) is a novel MIST for the treatment of BPH-LUTS. PAE leads to ischemic shrinkage of the prostate, thereby improving the LUTS problem. In addition, after prostate embolization, α1 receptor density decreases and smooth muscle relaxes, which may enhance the improvement effect.
However, the advantage of naturopathy in treating BPH-LUTS without any side effects is drawing the attention of more and more patients and experts. For example, the proprietary formula of Wuhan Dr.Lee TCM Clinic, Diuretic and Anti-inflammatory Pill, its unique diuretic and stranguria- treating effect can eliminate the patient's symptoms of urinary frequency and urgency, and the effect of blood-circulation promotion and Qi activation can eliminate various kinds of bulge, stingy or burning pain, and regulate Qi and blood.

Besides, anti-proliferative and anti-fibrotic effects of Diuretic and Anti-inflammatory Pill effectively inhibit the proliferation of residual lesions, prevent recurrence, and achieve the purpose of curing the disease of BPH.