Objective To systematically evaluate the quality of clinical practice guidelines (CPG) for medically treating benign prostatic hyperplasia (BPH), and to compare the context of recommendations in order to provide references for clinical application. Methods We searched databases of National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), National Institute for Health and Clinical Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN) and World Health Organization (WHO), PubMed, Embase, CNKI, VIP, WanFang Data, CBM, and Medlive from their establishment to October 13, 2019, to collect evidence-based guidelines and/or consensus on BPH. Method quality of included guidelines was assessed according to the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, and differences and similarities among recommendations were compared. Results A total of 22 guidelines were included, of which eight were updated versions. According to the AGREE II instrument, the median score of scope and purpose, stakeholder involvement, rigor of formulate, clarity of presentation, applicability, and editorial independence was 71.5%, 41%, 25%, 64%, 18%, and 28%, respectively. Based on recommendations for medical treatment, almost all guidelines recommended α1-blockers and 5α-reductase inhibitors, and most guidelines also recommended muscarinic receptor antagonists. In terms of drug combination therapy, most guidelines recommended "α1 blockers and 5α-reductase inhibitors", and some guidelines also recommended "α1 blockers and muscarinic receptor antagonists". Conclusion The recommendations from different guidelines were basically similar, only showing conflicts in some areas. The quality of included guidelines remains to be unified, and their context can provide valuable implications for development or improvement.

/pdf/a1-blockers-and-5a-reductase-inhibitors-are-the-most-3qtzn581a1.pdf

α1-Blockers and 5α-Reductase Inhibitors Are the Most Recommended Drugs in Treating Benign Prostatic Hyperplasia: An Evidence-Based Evaluation of Clinical Practice Guidelines.

Benign prostatic hyperplasia is a common cause of lower urinary tract symptoms. Men who are treated for benign prostatic hyperplasia potentially reduce their lifetime risk of acute urinary retention and the need for benign prostatic hyperplasia-related surgery. In this review, the treatment options of benign prostatic hyperplasia as related to lower urinary tract symptoms are summarized.

http://www.turkishjournalofurology.com/sayilar/5/buyuk/228-32.pdf

Treatment options in benign prostate hyperplasia associated with lower urinary tract symptoms

Benign prostatic hyperplasia (BPH) is a common condition that affects ageing men and is often associated with bothersome lower urinary tract symptoms which can affect quality of life. This review will discuss the condition, as well as potential treatment options and products, which should be avoided in patients with BPH.

A review of medicines used to treat benign prostatic hyperplasia : review

Silodosin is a specific alpha-1A receptor inhibitor newly available in South Africa. It offers a real solution to symptoms of BPH especially in those patients with moderate prostate enlargement experiencing nocturia, frequency and incomplete voiding.It can be safely used in patients who cannot tolerate non-selective alpha blockers. The main side-effect is anejaculation, but this seldom leads to drug discontinuation. The rapid action and ongoing effectiveness of the drug offers swift relief for patients.

https://www.tandfonline.com/doi/pdf/10.1080/20786190.2014.978099

Silodosin — a safer alpha-blocker targeting benign prostatic hyperplasia

Silodosin is a specific alpha-1A receptor inhibitor newly available in South Africa. It offers a real solution to symptoms of BPH especially in those patients with moderate prostate enlargement experiencing nocturia, frequency and incomplete voiding. It can be safely used in patients who cannot tolerate non-selective alpha blockers. The main side-effect is anejaculation, but this seldom leads to drug discontinuation. The rapid action and ongoing effectiveness of the drug offers swift relief for patients.

https://medpharm.tandfonline.com/doi/pdf/10.1080/20786190.2014.978099

Benign prostatic hyperplasia (BPH) is one of the most common conditions affecting older men. Strictly speaking, BPH is a histological diagnosis, and the term benign prostatic enlargement (BPE) is used when there is detectable enlargement of the prostate that is clinically not malignant. As a result of BPH, as many as 1 in 3 men over the age of 45 experience bothersome lower urinary tract symptoms (LUTS) that affect daily activities and sleep patterns. This symptom complex was previously referred to as prostatism. LUTS are divided into storage symptoms, including daytime frequency and nocturia, and voiding symptoms, including hesitancy, decreased flow rate and post-micturition dribbling. LUTS may also be due to other causes of bladder outflow obstruction (BOO), such as a urethral stricture, or conditions causing neurological dysfunction of the bladder detrusor muscle or sphincter mechanisms.

Management of benign prostatic hyperplasia - South African Urological Association Guideline.

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Management of benign prostatic hyperplasia - South African Urological Association Guideline.