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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Evidence-based guidelines for the treatment of lower urinary tract symptoms related to uncomplicated benign prostatic hyperplasia in Italy: updated summary from AURO.it</title>
<author><name sortKey="Spatafora, Sebastiano" sort="Spatafora, Sebastiano" uniqKey="Spatafora S" first="Sebastiano" last="Spatafora">Sebastiano Spatafora</name>
</author>
<author><name sortKey="Casarico, Antonio" sort="Casarico, Antonio" uniqKey="Casarico A" first="Antonio" last="Casarico">Antonio Casarico</name>
</author>
<author><name sortKey="Fandella, Andrea" sort="Fandella, Andrea" uniqKey="Fandella A" first="Andrea" last="Fandella">Andrea Fandella</name>
</author>
<author><name sortKey="Galetti, Caterina" sort="Galetti, Caterina" uniqKey="Galetti C" first="Caterina" last="Galetti">Caterina Galetti</name>
</author>
<author><name sortKey="Hurle, Rodolfo" sort="Hurle, Rodolfo" uniqKey="Hurle R" first="Rodolfo" last="Hurle">Rodolfo Hurle</name>
</author>
<author><name sortKey="Mazzini, Elisa" sort="Mazzini, Elisa" uniqKey="Mazzini E" first="Elisa" last="Mazzini">Elisa Mazzini</name>
</author>
<author><name sortKey="Niro, Ciro" sort="Niro, Ciro" uniqKey="Niro C" first="Ciro" last="Niro">Ciro Niro</name>
</author>
<author><name sortKey="Perachino, Massimo" sort="Perachino, Massimo" uniqKey="Perachino M" first="Massimo" last="Perachino">Massimo Perachino</name>
</author>
<author><name sortKey="Sanseverino, Roberto" sort="Sanseverino, Roberto" uniqKey="Sanseverino R" first="Roberto" last="Sanseverino">Roberto Sanseverino</name>
</author>
<author><name sortKey="Pappagallo, Giovanni Luigi" sort="Pappagallo, Giovanni Luigi" uniqKey="Pappagallo G" first="Giovanni Luigi" last="Pappagallo">Giovanni Luigi Pappagallo</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">23205056</idno>
<idno type="pmc">3491760</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491760</idno>
<idno type="RBID">PMC:3491760</idno>
<idno type="doi">10.1177/1756287212463112</idno>
<date when="2012">2012</date>
<idno type="wicri:Area/Pmc/Corpus">000295</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000295</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Evidence-based guidelines for the treatment of lower urinary tract symptoms related to uncomplicated benign prostatic hyperplasia in Italy: updated summary from AURO.it</title>
<author><name sortKey="Spatafora, Sebastiano" sort="Spatafora, Sebastiano" uniqKey="Spatafora S" first="Sebastiano" last="Spatafora">Sebastiano Spatafora</name>
</author>
<author><name sortKey="Casarico, Antonio" sort="Casarico, Antonio" uniqKey="Casarico A" first="Antonio" last="Casarico">Antonio Casarico</name>
</author>
<author><name sortKey="Fandella, Andrea" sort="Fandella, Andrea" uniqKey="Fandella A" first="Andrea" last="Fandella">Andrea Fandella</name>
</author>
<author><name sortKey="Galetti, Caterina" sort="Galetti, Caterina" uniqKey="Galetti C" first="Caterina" last="Galetti">Caterina Galetti</name>
</author>
<author><name sortKey="Hurle, Rodolfo" sort="Hurle, Rodolfo" uniqKey="Hurle R" first="Rodolfo" last="Hurle">Rodolfo Hurle</name>
</author>
<author><name sortKey="Mazzini, Elisa" sort="Mazzini, Elisa" uniqKey="Mazzini E" first="Elisa" last="Mazzini">Elisa Mazzini</name>
</author>
<author><name sortKey="Niro, Ciro" sort="Niro, Ciro" uniqKey="Niro C" first="Ciro" last="Niro">Ciro Niro</name>
</author>
<author><name sortKey="Perachino, Massimo" sort="Perachino, Massimo" uniqKey="Perachino M" first="Massimo" last="Perachino">Massimo Perachino</name>
</author>
<author><name sortKey="Sanseverino, Roberto" sort="Sanseverino, Roberto" uniqKey="Sanseverino R" first="Roberto" last="Sanseverino">Roberto Sanseverino</name>
</author>
<author><name sortKey="Pappagallo, Giovanni Luigi" sort="Pappagallo, Giovanni Luigi" uniqKey="Pappagallo G" first="Giovanni Luigi" last="Pappagallo">Giovanni Luigi Pappagallo</name>
</author>
</analytic>
<series><title level="j">Therapeutic Advances in Urology</title>
<idno type="ISSN">1756-2872</idno>
<idno type="eISSN">1756-2880</idno>
<imprint><date when="2012">2012</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="section1-1756287212463112"><title>Background:</title>
<p>The first Italian national guidelines were developed by the Italian Association of Urologists and published in 2007. Since then, a number of new drugs or classes of drugs have emerged for the treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH), new data have emerged on medical therapy (monotherapies and combination therapies), new surgical techniques have come into practice, and our understanding of disease pathogenesis has increased. Consequently, a new update of the guidelines has become necessary.</p>
</sec>
<sec id="section2-1756287212463112"><title>Methods:</title>
<p>A structured literature review was conducted to identify relevant papers published between 1 August 2006 and 12 December 2010. Publications before or after this timeframe were considered only if they were recognised as important milestones in the field or if the literature search did not identify publications within this timeframe. The quality of evidence and strength of recommendations were determined according to the Grading of Recommendations Assessment, Development and Evaluation framework.</p>
</sec>
<sec id="section3-1756287212463112"><title>Main findings:</title>
<p>Decisions on therapeutic intervention should be based on the impact of symptoms on quality of life (QoL) rather than the severity of symptoms (International Prostate Symptom Score (IPSS) score). A threshold for intervention was therefore based on the IPSS Q8, with intervention recommended for patients with a score of at least 4. Several differences in clinical recommendations have emerged. For example, combination therapy with a 5α-reductase inhibitor plus α blocker is now the recommended option for the treatment of patients at risk of BPH progression. Other differences include the warning of potential worsening of cognitive disturbances with use of anticholinergics in older patients, the distinction between <italic>Serenoa repens</italic>
preparations (according to the method of extraction), and the clearly defined threshold of prostate size for performing open surgery (>80 g). While the recommendations included in these guidelines are evidence based, clinical decisions should also be informed by patients’ clinical and physical circumstances, as well as patients’ preferences and actions.</p>
</sec>
<sec id="section4-1756287212463112"><title>Conclusions:</title>
<p>These guidelines are intended to assist physicians and patients in the decision-making process regarding the management of LUTS/BPH, and support the process of continuous improvement of the quality of care and services to patients.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Ther Adv Urol</journal-id>
<journal-id journal-id-type="iso-abbrev">Ther Adv Urol</journal-id>
<journal-id journal-id-type="publisher-id">TAU</journal-id>
<journal-id journal-id-type="hwp">sptau</journal-id>
<journal-title-group><journal-title>Therapeutic Advances in Urology</journal-title>
</journal-title-group>
<issn pub-type="ppub">1756-2872</issn>
<issn pub-type="epub">1756-2880</issn>
<publisher><publisher-name>SAGE Publications</publisher-name>
<publisher-loc>Sage UK: London, England</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">23205056</article-id>
<article-id pub-id-type="pmc">3491760</article-id>
<article-id pub-id-type="doi">10.1177/1756287212463112</article-id>
<article-id pub-id-type="publisher-id">10.1177_1756287212463112</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Research</subject>
</subj-group>
</article-categories>
<title-group><article-title>Evidence-based guidelines for the treatment of lower urinary tract symptoms related to uncomplicated benign prostatic hyperplasia in Italy: updated summary from AURO.it</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Spatafora</surname>
<given-names>Sebastiano</given-names>
</name>
<aff id="aff1-1756287212463112">Department of Surgery, Azienda Ospedaliera S. Maria Nuova, viale Risorgimento 80, 42100 Reggio Emilia, Italy</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Casarico</surname>
<given-names>Antonio</given-names>
</name>
<aff id="aff2-1756287212463112">E.O. Ospedali Galliera, Genoa, Italy</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Fandella</surname>
<given-names>Andrea</given-names>
</name>
<aff id="aff3-1756287212463112">Casa di Cura Giovanni XXIII Monastier, Treviso, Italy</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Galetti</surname>
<given-names>Caterina</given-names>
</name>
<aff id="aff4-1756287212463112">Az S. Orsola-Malpighi, Bologna, Italy</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Hurle</surname>
<given-names>Rodolfo</given-names>
</name>
<aff id="aff5-1756287212463112">Humanitas Gavazzeni Hospital, Bergamo, Italy</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Mazzini</surname>
<given-names>Elisa</given-names>
</name>
<aff id="aff6-1756287212463112">S. Maria Nuova Hospital, Reggio Emilia, Italy</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Niro</surname>
<given-names>Ciro</given-names>
</name>
<aff id="aff7-1756287212463112">Italian Association of Family Doctors (AIMEF), Milano, Italy</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Perachino</surname>
<given-names>Massimo</given-names>
</name>
<aff id="aff8-1756287212463112">Santo Spirito Hospital, Casale Monferrato, Italy</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Sanseverino</surname>
<given-names>Roberto</given-names>
</name>
<aff id="aff9-1756287212463112">Hospital Umberto I, Salerno, Italy</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Pappagallo</surname>
<given-names>Giovanni Luigi</given-names>
</name>
<aff id="aff10-1756287212463112">P.F. Calvi Hospital, Noale, Italy</aff>
</contrib>
<contrib contrib-type="author"><collab>for the AURO.it BPH Guidelines Committee</collab>
</contrib>
</contrib-group>
<author-notes><corresp id="corresp1-1756287212463112"><email>s.spatafora@me.com</email>
</corresp>
</author-notes>
<pub-date pub-type="epub-ppub"><month>12</month>
<year>2012</year>
</pub-date>
<pmc-comment>Fake ppub date generated by PMC from publisher pub-date/@pub-type='epub-ppub' </pmc-comment>
<pub-date pub-type="ppub"><month>12</month>
<year>2012</year>
</pub-date>
<volume>4</volume>
<issue>6</issue>
<fpage>279</fpage>
<lpage>301</lpage>
<permissions><copyright-statement>© The Author(s), 2012</copyright-statement>
<copyright-year>2012</copyright-year>
<copyright-holder content-type="sage">SAGE Publications</copyright-holder>
</permissions>
<abstract><sec id="section1-1756287212463112"><title>Background:</title>
<p>The first Italian national guidelines were developed by the Italian Association of Urologists and published in 2007. Since then, a number of new drugs or classes of drugs have emerged for the treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH), new data have emerged on medical therapy (monotherapies and combination therapies), new surgical techniques have come into practice, and our understanding of disease pathogenesis has increased. Consequently, a new update of the guidelines has become necessary.</p>
</sec>
<sec id="section2-1756287212463112"><title>Methods:</title>
<p>A structured literature review was conducted to identify relevant papers published between 1 August 2006 and 12 December 2010. Publications before or after this timeframe were considered only if they were recognised as important milestones in the field or if the literature search did not identify publications within this timeframe. The quality of evidence and strength of recommendations were determined according to the Grading of Recommendations Assessment, Development and Evaluation framework.</p>
</sec>
<sec id="section3-1756287212463112"><title>Main findings:</title>
<p>Decisions on therapeutic intervention should be based on the impact of symptoms on quality of life (QoL) rather than the severity of symptoms (International Prostate Symptom Score (IPSS) score). A threshold for intervention was therefore based on the IPSS Q8, with intervention recommended for patients with a score of at least 4. Several differences in clinical recommendations have emerged. For example, combination therapy with a 5α-reductase inhibitor plus α blocker is now the recommended option for the treatment of patients at risk of BPH progression. Other differences include the warning of potential worsening of cognitive disturbances with use of anticholinergics in older patients, the distinction between <italic>Serenoa repens</italic>
preparations (according to the method of extraction), and the clearly defined threshold of prostate size for performing open surgery (>80 g). While the recommendations included in these guidelines are evidence based, clinical decisions should also be informed by patients’ clinical and physical circumstances, as well as patients’ preferences and actions.</p>
</sec>
<sec id="section4-1756287212463112"><title>Conclusions:</title>
<p>These guidelines are intended to assist physicians and patients in the decision-making process regarding the management of LUTS/BPH, and support the process of continuous improvement of the quality of care and services to patients.</p>
</sec>
</abstract>
<kwd-group><kwd>benign prostatic hyperplasia</kwd>
<kwd>lower urinary tract symptoms</kwd>
<kwd>treatment guidelines</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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