ㅤTake-home message from McConnell 2003, published in New England Journal of Medicine:
Combination therapy (a-blocker and 5a-reductase inhibitor) is superior to monotherapy or no therapy in limiting the progression of benign prostatic hyperplasia.
ㅤTake-home message from Amanda L Lewis 2020, published in Health Technology Assessments:
Investigation of bothersome lower urinary tract symptoms (LUTS) using urodynamics versus standard care results in a non-inferior improvement in symptoms at 18 months, and similar rates of surgery. Including urodynamics was more expensive. The results do not support the routine use of urodynamics to investigate men with LUTS.
ㅤTake-home message from Ahyai 2010, published in European Urology:
In patients with benign prostatic hyperplasia (BPH), minimally invasive surgical therapies (MIST) have comparable efficacy and morbidity to transurethral resection of the prostate (TURP).
Varied safety profile and lack of long-term outcome measures for MIST mean that careful technique selection individualised to the patient is advised.
ㅤTake-home message from Philip van Kerrebroeck 2013, published in European Urology:
Combination tamsulosin 0.4 mg + solifenacin 6 mg was non-inferior to tamsulosin 0.4 mg alone in the improvement of voiding lower urinary tract symptoms and superior for storage lower urinary tract symptoms in men presenting with mixed symptoms, when compared to placebo.
The combination treatment was safe and well tolerated by most men.
Increasing the dose of solifenacin to 9mg was not of additional benefit
ㅤTake-home message from CG Roehrborn 2009, published in European Urology:
The occurrence of drug-related adverse events was significantly greater in the combination group, primarily due to the increased incidence of ejaculatory disorders. But no significant difference in withdrawal rates due to adverse events.
ㅤTake-home message from James A Thomas 2016, published in European Urology:
The use of GreenLight XPS laser system (GL-XPS) showed non-inferiority in both efficacy and safety to TURP for management of benign prostatic obstruction over the course of two years.
ㅤTake-home message from Rukstalis 2019, published in Journal of Endourology:
The sudy shows that the Prostatic Urethral Lift (PUL) procedure is safe and effective for treating lower urinary tract symptoms caused by an enlarged middle/median lobe of the prostate.
Patients experienced significant improvement in symptoms, quality of life and maximum urine flow, with no serious complications or adverse effects on sexual function.
The implant system is a promising treatment option for men with enlarged median lobes of the prostate who want to avoid more invasive surgery.
ㅤTake-home message from McNeil 2004, published in The Journal of Urology:
Alfuzosin increased successful TWOC
48% placebo v 62% Alfuzosin (p=0.012)
Alfuzosin was well tolerated even in elderly men (2.5% postural hypotension incidence)
(Second phase McNeil 2005: Alfuzosin 10mg OD also reduced need for BPH surgery during a 6-month treatment period)
ㅤTake-home message from Gilling 2012, published in BJU International:
HoLEP is non-inferior to TURP for relief of bladder outflow obstruction, with fewer re-operations at 7 years follow up
ㅤTake-home message from Fisher 2014, published in Cochrane Database of Systematic Reviews:
Alpha blockers can increase the chances of successful removal of a urinary catheter following presentation with acute urinary retention. Alpha blockers may also reduce the risk of further episodes of retention and have limited and comparable side effects to patients receiving a placebo (dummy) drug or no treatment.
ㅤTake-home message from J D McConnell 1998, published in The New England Journal of Medicine:
Among men with symptoms of urinary obstruction and prostatic enlargement, treatment with finasteride for four years reduces symptoms and prostate volume, increases the urinary flow
rate, and reduces the probability of surgery and acute urinary retention.
ㅤTake-home message from John M Fitzpatrick 2011, published in BJU International:
Can you tell me about a study that examined the management practices of acute urinary retention in men with benign prostatic hyperplasia (BPH)?
ㅤTake-home message from Wasson 1995, published in New England Journal of Medicine:
TURP is more effective than watchful waiting to treat men with moderate or bothersome BPH symptoms. Watchful waiting is a safe alternative for men less bothered by urinary symptoms or who want to delay surgery
ㅤTake-home message from Kevin McVary 2016, published in The Journal of Urology:
In this US multicentre randomised sham-controlled trial, Rezum produced a rapid and durable improvement in male LUTS whilst preserving erectile and ejaculatory function and without serious adverse events. The majority needed a catheter post-operatively for an average of 3 days.
ㅤTake-home message from Steven J. Jacobsen 1999, published in The Journal of Urology:
Nearly 1 in 4 men will receive BPH treatment (medical or surgical) in their 80s. Men with moderate-to-severe LUTS, reduced flow, or larger prostates are more likely to undergo treatment and these were also associated with other adverse outcomes including acute urinary retention.
ㅤTake-home message from Claus Roehrborn 2017, published in Canadian Journal of Urology:
In this 5-year follow-up of an international multicentre blinded sham-controlled randomised-controlled trial, UroLift under local anaesthetic for 30-80mL prostates demonstrates durable improvements in LUTS, flow and quality-of-life without compromise in sexual function, causing incontinence, or other safety concerns.
ㅤTake-home message from Christian Gratzke 2016, published in BJU International:
In men with symptomatic Benign Prostatic Hyperplasia (BPH), both Prostate Urethral Lift (PUL) and Transurethral Resection of Prostate (TURP) procedures improved lower urinary tract symptoms, quality of life and maximum flow rate (Q max).
TURP was superior for an improvement in IPSS compared to PUL
PUL was superior for quality of recovery, continence in the first 3 months and long term ejaculatory function
ㅤTake-home message from Alistair F Ray 2018, published in BJU International:
In patients presenting BPH with LUTS:
PAE was efficacious, but not non-inferior to TURP in International Prostate Symptom Score (IPSS) improvement.
PAE offered a reduced length of hospital stay compared to TURP (0 v 2 days) and faster return to usual activities (5 v 14 days).
Reported complications for both procedures were minor (Clavien-Dindo 1-2).