• Journal of Preventive Medicine and Public Health
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• v.30 no.3 s.58
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• pp.643-664
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• 1997

This study is to provide evidence-based recommendations for the most-effective treatments of benign prostatic hyperplasia based on patient preference or clinical need, and to meta-analyze the Korean literatures for the development of BPH treatment guidelines. For these analyses, extensive literature searches (208 articles), with priority given to the Korean Journal of Urology, were conducted from 1960 to August, 1996. Meta-analysis, like all statistical analysis, has two main functions: data summarization (qualitative meta-analysis) and smoothing o. pattern recognition (quantitative meta-analysis). As well, critical reviews and syntheses with the mean and 90-percent confidence intervals for the likelihood were used to evaluate empirical evidence and significant outcomes of the BPH treatment literatures (106 articles). For this task, the Methodologic Panel for BPH Guidelines was composed of multidisciplinary experts in the field. The results of the study were summarized as follows: For all that watchful waiting is an appropriate treatment strategy for the majority of patients with prostatism, we couldn't find the Korean literatures which carried this article. The literatures on alpha-1-adrenergic receptor blockers provide no evidence to suggest that any one alpha blocker is more effective than another. The finasteride reduces the size of the prostate, on average, and leads to a small yet perceptible reduction in sysptoms. Of all treatment options, prostate surgery with transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and so on, offers the best chance for symptom improvement. However, surgery also has the highest rates of significant complications. Therefore, surgery need not always be a treatment of last resort. Balloon dilation of the prostatic urethra is clearly less effective than surgery in relieving symptoms, but it is associated with fewer complications. Emerging technologies for treating BPH include lasers, coils, stents, thermal therapy and hyperthermia. Established technologies will also be reanalyzed as results of new trials are reported. Although this study has some limitations due to lacking for good quality literatures, ' it provides a cornerstone for our medical research. It represents the most current scientific knowledge regarding the clinical epidemiology including treatment of BPH. It will be revised and updated as needed.

• The Journal of Internal Korean Medicine
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• v.41 no.6
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• pp.1052-1065
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• 2020

Objectives: To evaluate the reliability of a pattern identification tool for benign prostatic hyperplasia and to examine the relationship between pattern identification tool readings and IPSS and uroflowmetry. Methods: We analyzed 56 patients diagnosed with benign prostatic hyperplasia from December 27th, 2017 to December 26th, 2018 by two different Korean medical doctors and followed with a pattern identification tool and by IPSS and uroflowmetry. One week later, the patients were retested to analyze the reliability of the pattern identification tool, determined with the intraclass correlation coefficient (ICC) using the test-retest method. The correlation between IPSS and uroflowmetry was analyzed with the Pearson coefficient. Result: The reliability of the pattern identification tool for benign prostatic hyperplasia was evaluated as "poor agreement beyond chance" (ICC=0.349). The reliability of each pattern identification score was evaluated as "good" for Yang Deficiency of Kidney, Yin Deficiency of Kidney, Deficiency of Middle Qi, and Dampness-heat of Lower Energizer. The internal consistency was evaluated as "good" for Yang Deficiency of Kidney, Yin Deficiency of Kidney, and Dampness-heat of Lower Energizer, and as "excellent" for Deficiency of Middle Qi. The correlation between pattern identification and IPSS was evaluated as a "moderate positive correlation" for all pattern identifications. The average flow rate and maximum flow rate using uroflowmetry was evaluated with "moderate negative correlation" for Yang Deficiency of Kidney and Dampness-heat of Lower Energizer. Conclusion: The reliability of a pattern identification tool for benign prostatic hyperplasia was evaluated as "poor agreement beyond chance." Further research is needed.

• Journal of Preventive Medicine and Public Health
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• v.42 no.3
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• pp.165-170
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• 2009

Objectives : We evaluated the risk of fracture associated with hypotension-related adverse drug reaction caused by taking alpha blockers to treat benign prostatic hyperplasia (BPH). Methods : We used the Health Insurance Review and Assessment Service database from January 1st 2005 to June 30th 2006 for this study. The male patients with BPH and who had a prescription for alpha blockers following any fractures were defined as the cases. We set the 20 day long hazard period prior to the index date and the four control periods whose lengths were same with hazard period. After 1:4 matching of the hazard and control periods, conditional logistic regression was used to calculate the odds ratios for the risk of fractures as related to the alpha blocker exposure. Results : Doxazosin and tamsulosin showed the increased risk of fractures, whereas terazosin did not. After stratification using the defined daily doses, a protective effect was shown for the patients who took terazosin at the doses lower than 0.4 DDD and the hazardous effect at the doses higher than or equal to 0.4 DDD. There was no significant difference for the risk of patients taking tamsulosin at the doses higher than 1.0 DDD but there was a statistically significant increase in the risk at the doses higher than or equal to 1.0 DDD. Conclusions : Alpha blockers for BPH may increase the risk of fracture in elderly patients who have comorbidities and take the concomitant medications. Alpha blockers need to be prescribed with caution, although some have high prostate specificity.