Guideline Statements
指南薈萃
Evaluation and Preoperative testing
評估和術前檢查
1. Clinicians should take a medical history and utilize the AUA-Symptom Index (AUA-SI) and urinalysis in the initial evaluation of patients presenting with bothersome LUTS possibly attributed to BPH; select patients may also require post-void residual (PVR), uroflowmetry, or pressure flow studies. (Clinical Principle)
1.對BPH相關的LUTS的患者進行初步評估，臨床醫生應詳細了解病史，並通過AUA癥狀指數評分（AUA-SI）和尿檢等進行分析；部分選擇性患者可能需要進行殘餘尿、尿流率或壓力/尿流率測定等檢查。（臨床原則）
2. Clinicians should consider assessment of prostate size and shape via abdominal or transrectal ultrasound, or cystoscopy, or by preexisting cross-sectional imaging (i.e. magnetic resonance imaging [MRI]/ computed tomography [CT]) prior to surgical intervention for LUTS attributed to BPH. (Clinical Principle)
2.在BPH相關的LUTS行外科手術乾預前，臨床醫生應通過經腹或經直腸超聲、膀胱鏡檢查、或已有的橫斷面影像（即磁共振成像[MRI] /計算機斷層掃描[CT]）評估攝護腺大小和形狀。（臨床原則）
3. Clinicians should perform a PVR assessment prior to surgical intervention for LUTS attributed to BPH. (Clinical Principle)
3.對BPH相關的LUTS在外科手術乾預前，臨床醫生應進行殘餘尿評估。（臨床原則）
4. Clinicians should consider uroflowmetry prior to surgical intervention for LUTS attributed to BPH. (Clinical Principle)
4. 對BPH相關的LUTS行外科手術乾預前，臨床醫生應考慮行尿流率測定。（臨床原則）
5. Clinicians should consider pressure flow studies prior to surgical intervention for LUTS attributed to BPH when diagnostic uncertainty exists. (Expert Opinion)
5.當BPH相關的LUTS存在診斷不確定性時，臨床醫生在外科手術乾預前應進行壓力/尿流率測定。（專家意見）
外科治療
6.Surgery is recommended for patients who have renal insufficiency secondary to BPH, refractory urinary retention secondary to BPH, recurrent urinary tract infections (UTIs), recurrent bladder stones or gross hematuria due to BPH, and/or with LUTS attributed to BPH refractory to and/or unwilling to use other therapies. (Clinical Principle)
6.對繼發於BPH的腎功能不全、頑固性尿瀦留、複發性尿路感染(UTIs)、複發性膀胱結石或反覆肉眼血尿，（以及/或）難治性的BPH相關性LUTS（和/或）不願使用其他治療方法的患者，建議手術治療。（臨床原則）
7. Clinicians should not perform surgery solely for the presence of an asymptomatic bladder diverticulum; however, evaluation for the presence of BOO should be considered. (Clinical Principle)
7.臨床醫生不應僅由於無癥狀膀胱憩室而進行手術；但對評估存在膀胱出口梗阻者（BOO）可考慮手術治療。（臨床原則）
經尿道前列腺電切術（TURP）
8. TURP should be offered as a treatment option for men with LUTS attributed to BPH. (Moderate Recommendation; Evidence Level: Grade B)
8.對於BPH相關的LUTS男性患者，TURP可作為治療方法的選擇。（中等推薦;證據級別：B級）
9. Clinicians may use a monopolar or bipolar approach to TURP, depending on their expertise with these techniques. (Expert Opinion)
9.根據臨床醫師（TURP）技術的專業能力，切割電極可使用單極或雙極電刀。（專家意見）
Simple prostatectomy
10. Clinicians should consider open, laparoscopic or robotic assisted prostatectomy, depending on their expertise with these techniques, for patients with large prostates. (Moderate Recommendation; Evidence Level: Grade C)
10.對於大體積攝護腺患者，臨床醫生應根據他們技術專業水準，選擇開放手術、腹腔鏡或機器人輔助攝護腺切除術。（中等推薦;證據級別：C級）
Transurethral inclsion of the prostate(TUIP)
11. TUIP should be offered as an option for patients with prostates ≤30g for the surgical treatment of LUTS attributed to BPH. (Moderate Recommendation; Evidence Level: Grade B)
11. 對於攝護腺（體積）≤30g的BPH相關的LUTS患者，TUIP應作為手術治療的一種選擇。（中等推薦;證據級別：B級）
Transurethral vaporization of the prostate(TUVP)
12. Bipolar TUVP may be offered to patients for the treatment of LUTS attributed to BPH. (Conditional Recommendation; Evidence Level: Grade B)
12.雙極等離子汽化電切術可用於治療BPH相關的LUTS。（有條件推薦;證據級別：B級）
13. Clinicians should consider PVP as an option using 120W or 180W platforms for patients for the treatment of LUTS attributed to BPH. (Moderate Recommendation; Evidence Level: Grade B)
13.臨床醫生可考慮使用120W或180W能量平台PVP治療BPH相關的LUTS患者。（中等推薦;證據級別：B級）
攝護腺段尿道懸吊術（PUL）
14. Clinicians should consider PUL as an option for patients with LUTS attributed to BPH provided prostate volume <80g and verified absence of an obstructive middle lobe; however, patients should be informed that symptom reduction and flow rate improvement is less significant compared to TURP. Patients should be informed that evidence of efficacy and retreatment rates are poorly defined. (Moderate Recommendation; Evidence Level: Grade C)
14.對於攝護腺體積<80g，且非中葉阻塞型BPH相關的LUTS患者，臨床醫生可考慮行攝護腺段尿道懸吊術（PUL）；但應告知患者（該術式術後）癥狀緩解與尿流率改善效果不及TURP。（醫生）應告知患者（該術式）有效性和再次治療率暫未明確。（中等推薦;證據級別：C級）
15. PUL may be offered to eligible patients concerned with erectile and ejaculatory function for the treatment of with LUTS attributed to BPH. (Conditional Recommendation; Evidence Level: Grade C)
15.治療BPH相關的LUTS，攝護腺段尿道懸吊術（PUL）可用於對勃起和射精功能需求且符合條件的患者。（有條件推薦;證據級別：C級）
Transurethral microwave therapy (TUMT)
16. TUMT may be offered to patients with LUTS attributed to BPH; however, patients should be informed that surgical retreatment rates are higher compared to TURP. (Conditional Recommendation; Evidence Level: Grade C)
16.經尿道微波熱療（TUMT）可用於治療BPH相關的LUTS患者；但應告知患者再次手術率高於TURP。（有條件推薦;證據級別：C級）
Water vapor thermal therapy
水蒸氣（消融）熱療法
17. Water vapor thermal therapy may be offered to patients with LUTS attributed to BPH provided prostate volume <80g; however, patients should be counseled regarding efficacy and retreatment rates. (Conditional Recommendation; Evidence Level: Grade C)
17.對攝護腺體積<80g BPH相關的LUTS患者，可採用（攝護腺）水蒸氣消融療法；然而，（該術式的）療效和複發率方面應告知患者。（有條件推薦;證據級別：C級）
18. Water vapor thermal therapy may be offered to eligible patients who desire preservation of erectile and ejaculatory function. (Conditional Recommendation; Evidence Level: Grade C)
18. 水蒸氣消融療法可用於希望保留勃起和射精功能的患者。（有條件推薦;證據級別：C級）
Transurethral needle ablation (TUNA)
19. TUNA is not recommended for the treatment of LUTS attributed to BPH. (Expert Opinion)
19.不建議將經尿道針刺消融術（TUNA）用於治療由BPH引起的LUTS。（專家意見）
雷射剜除術
20. Clinicians should consider holmium laser enucleation of the prostate (HoLEP) or thulium laser enucleation of the prostate (ThuLEP), depending on their expertise with either technique, as prostate size-independent suitable options for the treatment of LUTS attributed to BPH. (Moderate Recommendation; Evidence Level: Grade B)
20.臨床醫生應考慮採用鈥雷射攝護腺剜除術（HoLEP）或銩雷射攝護腺剜除術（ThuLEP），HoLEP及ThuLEP對攝護腺體積沒有要求，術者應根據自己的專長選擇合適的術式治療BPH相關LUTS。（中等推薦;證據級別：B級）
Aquablation
攝護腺水刀
21. Aquablation may be offered to patients with LUTS attributed to BPH provided prostate volume >30/<80g, however, patients should be informed that long term evidence of efficacy and retreatment rates, remains limited. (Conditional Recommendation; Evidence Level: Grade C)
21.攝護腺水刀（Aquablation）可用於治療攝護腺體積體積介於 30-80g BPH相關的LUTS患者，但應告知有效性和複發率的長期證據仍然有限。（有條件的建議;證據級別：C級）
Prostate artery embolization (PAE)
攝護腺動脈栓塞術（PAE）
22. PAE is not recommended for the treatment of LUTS attributed to BPH outside the context of a clinical trial. (Expert Opinion)
22.在臨床試驗範圍之外，不推薦PAE用於治療BPH相關的LUTS。（專家意見）
Medically complicated patients
醫學上複雜的患者
23. HoLEP, PVP, and ThuLEP should be considered in patients who are at higher risk of bleeding, such as those on anti-coagulation drugs. (Expert Opinion)
23.對於使用抗凝血藥物等出血風險較高的患者，應考慮使用HoLEP，PVP和ThuLEP。（專家意見）
*翻譯僅供學習交流，不作為臨床實踐標準
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