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Benign Prostatic Hyperplasia

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1. Benign Prostatic Hyperplasia: Surgical Management of Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms

Benign Prostatic Hyperplasia: Surgical Management of Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms 1 Purpose Benign prostatic hyperplasia (BPH) is a histologic diagnosis that refers to the proliferation of smooth muscle and epithelial cells within the prostatic transition zone. The prevalence and the severity of lower urinary tract symptoms (LUTS) in the aging male can be progressive and is an important diagnosis in the healthcare of patients and the welfare of society (...) Urological Association (AUA) Surgical Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA GUIDELINE Harris E. Foster, MD; Michael J. Barry, MD; Philipp Dahm, MD; Manhar C. Gandhi, MD; Steven A. Kaplan, MD; Tobias S. Kohler, MD; Lori B. Lerner, MD; Deb J. Lightner, MD; J. Kellogg Parsons, MD; Claus G. Roehrborn, MD; Charles Welliver, MD; Timothy J. Wilt, MD; Kevin T. McVary, MD Copyright © 2019 American Urological Association Education and Research, Inc.® 2 American

2019 American Urological Association

2. Benign Prostatic Hyperplasia: Surgical Management of Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms

Benign Prostatic Hyperplasia: Surgical Management of Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms Benign Prostatic Hyperplasia (BPH) Guideline - American Urological Association advertisement Toggle navigation About Us About the AUA Membership AUA Governance Industry Relations Education AUAUniversity Education Products & Resources Normal Histology and Important Histo-anatomic Structures Urinary Bladder Prostate Kidney Renovascular Diseases Andrenal Gland Testis Paratesticular Tumors (...) Resources Coding and Reimbursement Practice Managers' Network (PMN) Patient Safety and Quality of Care Accreditations and Reporting Patient Education Benign Prostatic Hyperplasia: Surgical Management of Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms (2018, amended 2019) Published 2018, Amended 2019 The goal of this revised guideline is to provide a useful reference on the effective evidence-based surgical management of male lower urinary tract symptoms secondary to benign prostatic

2019 American Urological Association

3. Prostatic urethral temporary implant insertion for lower urinary tract symptoms caused by benign prostatic hyperplasia

Prostatic urethral temporary implant insertion for lower urinary tract symptoms caused by benign prostatic hyperplasia Prostatic urethr Prostatic urethral tempor al temporary implant insertion ary implant insertion for lower urinary tr for lower urinary tract symptoms caused b act symptoms caused by y benign prostatic h benign prostatic hyperplasia yperplasia Interventional procedures guidance Published: 30 January 2019 nice.org.uk/guidance/ipg641 Y Y our responsibility our responsibility (...) NICE recommendations wherever possible. 1 1 Recommendations Recommendations 1.1 Current evidence on the safety and efficacy of prostatic urethral temporary implant insertion for lower urinary tract symptoms caused by benign prostatic hyperplasia is limited in quantity and quality. Therefore, this procedure should © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 4only be used in the context of research. 1.2

2019 National Institute for Health and Clinical Excellence - Interventional Procedures

4. Prostate artery embolisation for lower urinary tract symptoms caused by benign prostatic hyperplasia

Prostate artery embolisation for lower urinary tract symptoms caused by benign prostatic hyperplasia Prostate artery embolisation for lower urinary Prostate artery embolisation for lower urinary tr tract symptoms caused b act symptoms caused by benign prostatic y benign prostatic h hyperplasia yperplasia Interventional procedures guidance Published: 24 April 2018 nice.org.uk/guidance/ipg611 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after (...) Recommendations Recommendations 1.1 Current evidence on the safety and efficacy of prostate artery embolisation for benign prostatic hyperplasia is adequate to support the use of this procedure © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 4provided that standard arrangements are in place for clinical governance, consent and audit. 1.2 Patient selection should be done by a urologist and an interventional radiologist

2018 National Institute for Health and Clinical Excellence - Interventional Procedures

5. Prostatic urethral lift for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia. (Abstract)

Prostatic urethral lift for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia. A variety of minimally invasive surgical approaches are available as an alternative to transurethral resection of prostate (TURP) for the management of lower urinary tract symptoms (LUTS) in men with benign prostatic hyperplasia (BPH). A recent addition to these is prostatic urethral lift (PUL).To assess the effects of PUL for the treatment of LUTS in men with BPH.We performed (...) not find any non-RCTs.Two review authors independently screened the literature, extracted data, and assessed risk of bias. We performed statistical analyses using a random-effects model and interpreted them according to the Cochrane Handbook for Systematic Reviews of Interventions. We planned subgroup analyses by age, prostate volume, and severity of baseline symptoms. We used the GRADE approach to rate the certainty of the evidence.We included two RCTs with 297 participants comparing PUL to sham

2019 Cochrane Controlled trial quality: predicted high

6. Aquablation of the prostate for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia. (Full text)

Aquablation of the prostate for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia. New, minimally invasive surgeries have emerged as alternatives to transurethral resection of the prostate (TURP) for the management of lower urinary tract symptoms (LUTS) in men with benign prostatic hyperplasia (BPH). Aquablation is a novel, minimally invasive, water-based therapy, combining image guidance and robotics for the removal of prostatic tissue.To assess the effects (...) of Aquablation for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia.We performed a comprehensive search using multiple databases (the Cochrane Library, MEDLINE, Embase, Scopus, Web of Science, and LILACS), trials registries, other sources of grey literature, and conference proceedings published up to 11 February 2019, with no restrictions on the language or status of publication.We included parallel-group randomised controlled trials (RCTs) and cluster-RCTs, as well

2019 Cochrane PubMed abstract

7. Transurethral water jet ablation for lower urinary tract symptoms caused by benign prostatic hyperplasia

Transurethral water jet ablation for lower urinary tract symptoms caused by benign prostatic hyperplasia T T r ransurethr ansurethral water jet ablation for lower urinary al water jet ablation for lower urinary tr tract symptoms caused b act symptoms caused by benign prostatic y benign prostatic h hyperplasia yperplasia Interventional procedures guidance Published: 19 September 2018 nice.org.uk/guidance/ipg629 Y Y our responsibility our responsibility This guidance represents the view of NICE (...) possible. 1 1 Recommendations Recommendations 1.1 The evidence on transurethral water jet ablation for lower urinary tract symptoms caused by benign prostatic hyperplasia raises no major safety concerns. The evidence on efficacy is limited in quantity. Therefore, this © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 5procedure should only be used with special arrangements for clinical governance, consent, and audit

2018 National Institute for Health and Clinical Excellence - Interventional Procedures

8. Transurethral water vapour ablation for lower urinary tract symptoms caused by benign prostatic hyperplasia

Transurethral water vapour ablation for lower urinary tract symptoms caused by benign prostatic hyperplasia T T r ransurethr ansurethral water vapour ablation for lower al water vapour ablation for lower urinary tr urinary tract symptoms caused b act symptoms caused by benign y benign prostatic h prostatic hyperplasia yperplasia Interventional procedures guidance Published: 21 August 2018 nice.org.uk/guidance/ipg625 Y Y our responsibility our responsibility This guidance represents the view (...) possible. 1 1 Recommendations Recommendations 1.1 Current evidence on the safety and efficacy of transurethral water vapour ablation for urinary tract symptoms caused by benign prostatic hyperplasia is © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 4adequate to support the use of this procedure provided that standard arrangements are in place for clinical governance, consent and audit. 1.2 This procedure should

2018 National Institute for Health and Clinical Excellence - Interventional Procedures

9. Endoscopic non-contact (side-firing) visual laser ablation of the prostate (VLAP) for benign prostatic hyperplasia (BPH)

Endoscopic non-contact (side-firing) visual laser ablation of the prostate (VLAP) for benign prostatic hyperplasia (BPH) 1 Public Summary Document Application No. 1518 – Endoscopic visual laser ablation of the prostate (VLAP) for benign prostatic hyperplasia Applicant: Boston Scientific Date of MSAC consideration: MSAC 75 th Meeting, 28-29 March 2019 Context for decision: MSAC makes its advice in accordance with its Terms of Reference, visit the MSAC website 1. Purpose of application (...) An application examining the evidence to support an increase in the Medicare Benefits Schedule (MBS) fee for endoscopic visual laser ablation of the prostate (VLAP), also known as photoselective vaporisation of the prostate [PVP] for men with benign prostate hyperplasia (BPH) was received from Boston Scientific Pty Ltd by the Department of Health. 2. MSAC’s advice to the Minister After considering the strength of the available evidence in relation to comparative safety, clinical effectiveness and cost

2019 Medical Services Advisory Committee

10. Rezum for treating benign prostatic hyperplasia

Rezum for treating benign prostatic hyperplasia Rezum for treating benign prostatic h Rezum for treating benign prostatic hyperplasia yperplasia Medtech innovation briefing Published: 24 August 2018 nice.org.uk/guidance/mib158 pathways Summary Summary The technology technology described in this briefing is Rezum, which uses steam to ablate prostate tissue with the aim of improving lower urinary tract symptoms secondary to benign prostatic hyperplasia. The inno innovativ vative aspects e aspects (...) are that the company claims that it is quicker to do than existing treatments and can be done as a day case. The intended place in ther place in therap apy y would be as an alternative to current standard care in people with lower urinary tract symptoms presumed to be secondary to benign prostatic hyperplasia. The main points from the e main points from the evidence vidence summarised in this briefing are from 4 studies (blinded control trial, 1 single-arm pilot study and 2 retrospective observational studies

2018 National Institute for Health and Clinical Excellence - Advice

11. Minimally-Invasive Treatments for Lower Urinary Tract Symptoms in People with Benign Prostatic Hyperplasia: A Review of Clinical Effectiveness

Minimally-Invasive Treatments for Lower Urinary Tract Symptoms in People with Benign Prostatic Hyperplasia: A Review of Clinical Effectiveness Minimally-Invasive Treatments for Lower Urinary Tract Symptoms in People with Benign Prostatic Hyperplasia: A Review of Clinical Effectiveness | CADTH.ca Find the information you need Minimally-Invasive Treatments for Lower Urinary Tract Symptoms in People with Benign Prostatic Hyperplasia: A Review of Clinical Effectiveness Minimally-Invasive Treatments (...) for Lower Urinary Tract Symptoms in People with Benign Prostatic Hyperplasia: A Review of Clinical Effectiveness Last updated: August 29, 2019 Project Number: RC1172-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of select minimally-invasive treatments for the management of lower urinary tract symptoms in people with benign prostatic hyperplasia? Key Message Four recent systematic reviews

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

12. Silodosin Recordati - benign prostatic hyperplasia (BPH)

Silodosin Recordati - benign prostatic hyperplasia (BPH) 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5555 Send a question via our website www.ema.europa.eu/contact © European Medicines Agency, 2019. Reproduction is authorised provided the source is acknowledged. EMA/815843/2018 EMEA/H/C/004964 Silodosin Recordati (silodosin) An overview of Silodosin Recordati and why it is authorised (...) in the EU What is Silodosin Recordati and what is it used for? Silodosin Recordati is a medicine used to treat the symptoms of benign prostatic hyperplasia (BPH, an enlarged prostate gland) in adults. The prostate gland is an organ found at the base of the bladder in men. When enlarged, it can cause problems with the flow of urine. This medicine is identical to Urorec, which has been authorised in the EU since 29 January 2010. How is Silodosin Recordati used? Silodosin Recordati can only be obtained

2019 European Medicines Agency - EPARs

13. Dutasteride, tamsulosin, alfuzosin and dutasteride/tamsulosin combination for benign prostatic hyperplasia

Dutasteride, tamsulosin, alfuzosin and dutasteride/tamsulosin combination for benign prostatic hyperplasia 1 Driving better decision-making in healthcare Dutasteride, tamsulosin, alfuzosin and dutasteride/tamsulosin combination for treating benign prostatic hyperplasia Technology Guidance from the MOH Drug Advisory Committee Update published on 1 April 2020 Guidance Recommendations The Ministry of Health’s Drug Advisory Committee has recommended: ? Alfuzosin 10 mg tablet and dutasteride 0.5 mg (...) capsule for treating benign prostatic hyperplasia. Subsidy status Alfuzosin 10 mg tablet and dutasteride 0.5 mg capsule are recommended for inclusion on the MOH Standard Drug List (SDL). SDL subsidy does not apply to tamsulosin 0.4 mg tablet or dutasteride 0.5 mg/tamsulosin 0.4 mg capsule. 2 Driving better decision-making in healthcare Factors considered to inform the recommendations for subsidy Technology evaluation 1.1 1.2 1.3 1.4 The MOH Drug Advisory Committee (“the Committee”) considered

2020 Appropriate Care Guides, Agency for Care Effectiveness (Singapore)

14. Rezum for treating lower urinary tract symptoms secondary to benign prostatic hyperplasia

Rezum for treating lower urinary tract symptoms secondary to benign prostatic hyperplasia Rezum for treating lower urinary tract symptoms secondary to benign prostatic hyperplasia Medical technologies guidance Published: 24 June 2020 www.nice.org.uk/guidance/mtg49 © NICE 2020. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Your responsibility Your responsibility This guidance represents the view of NICE, arrived at after careful (...) urinary tract symptoms secondary to benign prostatic hyperplasia (MTG49) © NICE 2020. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 19Contents Contents 1 Recommendations 4 2 The technology 5 T echnology 5 Innovative aspects 5 Intended use 5 Costs 6 3 Evidence 7 Clinical evidence 7 Cost evidence 9 4 Committee discussion 11 Clinical-effectiveness overview 11 Side effects and adverse events 13 Relevance to the NHS 14 NHS

2020 National Institute for Health and Clinical Excellence - Medical technologies

15. Society of Interventional Radiology Multisociety Consensus Position Statement on Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia (Full text)

Society of Interventional Radiology Multisociety Consensus Position Statement on Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia Society of Interventional Radiology Multisociety Consensus Position Statement on Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: From the Society of Interventional Radiology, the Cardiovascular and Interventional Radiological (...) Attributed to Benign Prostatic Hyperplasia: From the Society of Interventional Radiology, the Cardiovascular and Interventional Radiological Society of Europe, Société Française de Radiologie, and the British Society of Interventional Radiology Endorsed by the Asia Pacific Society of Cardiovascular and Interventional Radiology, Canadian Association for Interventional Radiology, Chinese College of Interventionalists, Interventional Radiology Society of Australasia, Japanese Society of Interventional

2019 Society of Interventional Radiology PubMed abstract

16. Benign prostatic hyperplasia

Benign prostatic hyperplasia Benign prostatic hyperplasia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Benign prostatic hyperplasia Last reviewed: February 2019 Last updated: September 2018 Summary Multi-factorial involving smooth muscle hyperplasia, prostatic enlargement, and bladder dysfunction, as well as input from the central nervous system. Presents with both storage symptoms (frequency, urgency, nocturia (...) invasive therapy. Failure of medical management or renal complications are indications for surgical intervention. There are a host of procedural treatments, which have unique risk/benefit profiles for consideration. Definition Lower urinary tract symptoms (LUTS) caused by bladder outlet obstruction due to benign prostatic hyperplasia (BPH), also known as benign prostatic enlargement (BPE), are predominantly due to 2 components: a static component related to an increase in benign prostatic tissue

2018 BMJ Best Practice

17. Benign prostatic hyperplasia

Benign prostatic hyperplasia Benign prostatic hyperplasia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Benign prostatic hyperplasia Last reviewed: February 2019 Last updated: September 2018 Summary Multi-factorial involving smooth muscle hyperplasia, prostatic enlargement, and bladder dysfunction, as well as input from the central nervous system. Presents with both storage symptoms (frequency, urgency, nocturia (...) invasive therapy. Failure of medical management or renal complications are indications for surgical intervention. There are a host of procedural treatments, which have unique risk/benefit profiles for consideration. Definition Lower urinary tract symptoms (LUTS) caused by bladder outlet obstruction due to benign prostatic hyperplasia (BPH), also known as benign prostatic enlargement (BPE), are predominantly due to 2 components: a static component related to an increase in benign prostatic tissue

2018 BMJ Best Practice

18. Phosphodiesterase inhibitors for lower urinary tract symptoms consistent with benign prostatic hyperplasia. (Full text)

Phosphodiesterase inhibitors for lower urinary tract symptoms consistent with benign prostatic hyperplasia. Benign prostatic hyperplasia (BPH) refers to non-malignant enlargement of the prostate gland that may cause bothersome lower urinary tract symptoms (LUTS). Alpha-blockers (ABs) and 5-alpha reductase inhibitors (5-ARIs) are the mainstay of medical treatment. Recently, phosphodiesterase inhibitors (PDEIs) that so far have been used mainly to treat erectile dysfunction were introduced (...) reflecting more symptoms), urinary bother as assessed by the Benign Prostatic Hyperplasia Impact Index (BPHII; score ranging from 0 to 13, with higher values reflecting more bother), and adverse events (AEs). We used GRADE to rate the quality of evidence. We considered short-term (up to 12 weeks) and long-term (12 weeks or longer) results separately.We included a total of 16 randomised trials in this review. The results for primary outcomes are as follows.PDEI versus placebo: PDEIs may result in a small

2018 Cochrane PubMed abstract

19. Naftopidil for the treatment of lower urinary tract symptoms compatible with benign prostatic hyperplasia. (Full text)

Naftopidil for the treatment of lower urinary tract symptoms compatible with benign prostatic hyperplasia. Benign prostatic hyperplasia (BPH) is a common condition in ageing men that may cause lower urinary tract symptoms (LUTS). Treatment aims are to relieve symptoms and prevent disease-related complications. Naftopidil is an alpha-blocker (AB) that has a high affinity for the A1d receptor that may have advantages in treating LUTS in this setting. This is an update of a Cochrane Review first (...) years, prostate volume was 35.4 mL, and International Prostate Symptom Score was 18.3. We were unable to perform any of the preplanned subgroup analyses based on age and baseline symptom score.Naftopidil versus tamsulosinBased on 12 studies with 965 randomised participants, naftopidil may have resulted in little or no difference in urological symptom score (mean difference (MD) 0.47, 95% confidence interval (CI) -0.09 to 1.04 measured on a scale from 0 to 35 with higher score representing increased

2018 Cochrane PubMed abstract

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