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Titolo:
Changing therapeutic regimens in benign prostatic hyperplasia - Clinical and economic considerations
Autore:
Stoevelaar, HJ; McDonnell, J;
Indirizzi:
Erasmus Univ, Inst Hlth Care Policy & Management, NL-3000 DR Rotterdam, Netherlands Erasmus Univ Rotterdam Netherlands NL-3000 DR DR Rotterdam, Netherlands
Titolo Testata:
PHARMACOECONOMICS
fascicolo: 2, volume: 19, anno: 2001,
pagine: 131 - 153
SICI:
1170-7690(2001)19:2<131:CTRIBP>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSURETHRAL MICROWAVE THERMOTHERAPY; URINARY-TRACT SYMPTOMS; RANDOMIZED CONTROLLED TRIAL; TRANS-URETHRAL RESECTION; LONG-TERM EFFICACY; LASER-INDUCED PROSTATECTOMY; BLADDER NECK INCISION; 3-YEAR FOLLOW-UP; QUALITY-OF-LIFE; COMMON SURGICAL-PROCEDURES;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
221
Recensione:
Indirizzi per estratti:
Indirizzo: Stoevelaar, HJ Erasmus Univ, Inst Hlth Care Policy & Management, POB 1738,NL-3000 DR Rotterdam, Netherlands Erasmus Univ POB 1738 Rotterdam Netherlands NL-3000 DR nds
Citazione:
H.J. Stoevelaar e J. McDonnell, "Changing therapeutic regimens in benign prostatic hyperplasia - Clinical and economic considerations", PHARMACOECO, 19(2), 2001, pp. 131-153

Abstract

About one-quarter of men aged 50 years and older experience voiding problems due to benign prostatic hyperplasia (BPH). Until about 10 years ago, surgery (particularly transurethral resection of the prostate) was the only effective treatment for symptomatic BPH. Over the last decade, several new treatments have been introduced. These include different types of medication (alpha -blockers and finasteride), thermotherapy, laser prostatectomy, needle ablation and vaporisation methods. The diffusion of these less invasive treatment modalities has resulted not only in a decrease in the age-adjusted surgery rates, but also in an increase of the total number of men treatedfor BPH. A large number of studies on clinical benefits and risks reveal that the conventional types of surgery remain the most effective treatments,whereas new interventional therapies require a shorter hospital stay and result in fewer short term complications. The efficacy of medication is lower than that of interventional treatments. Adverse effects include dizzinessand orthostatic hypotension (alpha -blockers) and decreased sexual function (finasteride), but are generally mild. There is some evidence that medication and minimally invasive treatments may preclude eventual surgical treatment, but the precise effect is difficult to estimate because of differences in the study populations and the relatively short study periods. As a result of the dynamic nature of BPH treatment and the lack of long term data, the cost effects of the introduction of the various new treatments are also difficult to assess. Given the aging ofthe population and the growing percentage of patients with BPH for whom any type of treatment can be considered, a considerable increase of total costs can be expected. Long term prospective studies are necessary to gain insight into the most cost-effective treatment for different patient groups.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 16/07/20 alle ore 19:57:40