AUA updates advice on workup and management of benign prostatic hyperplasia

Reuters Health - 25/08/2021 - The workup and medical or surgical management of benign prostatic hyperplasia (BPH) requires attention to individual patient characteristics, updated guidelines from the American Urological Association (AUA) advise.

Guideline panel member Dr. Lori Lerner, with the VA Boston Healthcare System, in West Roxbury, Massachusetts, told Reuters Health the updated guidelines "contain similar subject matter to the prior ones, namely initial evaluation, work-up, medical management, and surgical therapies."

"However, several new areas are included, such as utilizing prostate imaging to further inform decisions in management, an introduction into the concept of re-treatment rates, new medications and surgical therapies, and discussions regarding alternative therapies and important future directions and needs within the field of LUTS attributed to BPH," she said by email.

The guidelines are published in two parts in The Journal of Urology.

Part one provides 19 recommendation statements pertinent to evaluation, work-up, and medical management of lower-urinary-tract symptoms (LUTS) attributed to BPH.

"Appropriate levels of evidence and supporting text were created to direct both primary care and urologic providers towards streamlined and suitable practices," the panel says.

Part two contains 24 recommendation statements relevant to pre-operative and surgical management.

"Appropriate levels of evidence and supporting text were created to direct urologic providers towards suitable and safe operative interventions for individual patient characteristics," the panel says.

"A re-treatment section was created to direct attention to longevity and outcomes with individual approaches to help guide patient counseling and therapeutic decisions," they note.

Dr. Lerner said it's her "hope that clinicians will actually read the guidelines and supporting text and understand the context in which these statements were developed."

"LUTS/BPH is an area that nearly every urologist has experience and deals with, yet there are many concepts that may not be fully appreciated," Dr. Lerner said.

"It is our hope, as a committee, that urologists and non-urology providers who deal with LUTS/BPH will review the material included here to provide their patients with complete and current information to make the best and most appropriate decisions for themselves," she told Reuters Health.

SOURCE: https://bit.ly/2UHDWk2 and https://bit.ly/2XOaaeF The Journal of Urology, online August 13, 2021.

By Megan Brooks



Posted on 25 August, 20213 September, 2021