Original Title: Terapéutica en la hiperplasia benigna de próstata

Authors' objectives: To analyse the current available therapies to treat Benign Prostatic Hyperplasia (BPH) and recommend those for which their efficacy is proved.

Authors' results and conclusions: Transurethral ressection of the Prostate(TURP) has been confirmed as the selected treatment for BHP and goold standard of the therapy options. Adenomectomy is recommended for the treatment of high prostate volumes (>60gr). New pharmacological treatment such as -reductase inhibitors or -blockers, may be efficient alternatives for cases with a light prostatic symptomatology. The above mentiones drugs produce an improvement (statistically significant) in the objective pattern of the prostatic syndrome. The introduction of temporary or permanent prothesis is a valid option for patients who cannot undergo more aggresive treatment or havve a short liife expectancy. Expectant surveillance is recommended in the case of light prostatism which does not affect the quality of life. Minimally invasive treatments such as microwaves, ttransrectal hyperthermia, transurethral thermotherapy, ultrasound waves, cryosurgery, prostatic exeresis with needles, laser, balloon dilatation with a ball, are still at the experimental stagee.

Authors' recommendations: TURP is the selected treatment for the absolute intervention indication. In moderate prostatism cases it is possible to use reductase inhibitor and blocker treatment, which have shown objective impr ovement, with a minimum toxicity. Patients with a high surgical risk or those who wish to avoid the erection dysfunction associated with TURP may also be treated in this way. The demand for an alternative technique has led to the clinical use of se veral procedures which have not yet proven their effectiveness nor their long term value. At present there is no alternative to TURP in relation to its efficiency, safety and cost. Preliminary studies suggest that adopting new therapy methods in BPH wou ld l ead to an increase in health costs. Controlled clinical studies together with the corresponding economic evaluation are necessary before a decision is taken about the introduction of each alternative.

Authors' methods: An exhaustive bibliographic search through Medline, and a collection of evaluations and research from other Technological Evalluation Services. Analysis and application to the Basque Country context by a group of urology specialists followed by an external revision by peers. An evaluation of TURP, different surgical alternatives and medication for the treatment of BPH. A cost-benefit analysis of the different therapy models.

Project Status: Completed

Year Published: 1994

URL for published report: https://www.euskadi.eus/contenidos/informacion/1994_osteba_publicacion/es_def/adjuntos/1994/d_94_02_terapeutica_hiperplasia_prostata.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: <p>Health Technology Assessment Unit, Health Department of the Basque Government</p>