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KMID : 0371019970300030643
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Journal of Preventive Medicine and Public Health
1997 Volume.30 No. 3 p.643 ~ p.664
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Meta-analysis of the Korean Literatures for Developing Clinical Practice Guidelines of Benign Prostatic Hyperplasia
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Yu Seung-Hum
Kim Chun-Bae
Kang Myung-Guen
Song Jae-Mann
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Abstract
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This study is to provide evidence-based recommendations for the most-effective treatments of benign prostatic hyperplasia based on patient preference or clinical need, and to meta-analyze the Korean literatures for the development of BPH treatment guidelines.
For these analyses, extensive literature searches (208 articles), with priority given to the Korean Journal of Urology, were conducted from 1960 to August, 1996. Meta-analysis, like all statistical analysis, has two main functions: data summarization (qualitative meta-analysis) and smoothing or pattern recognition (quantitative meta-analysis). As well, critical reviews and syntheses with the mean and 90-percent confidence intervals for the likelihood were used to evaluate empirical evidence and significant out-comes of the BPH treatment literatures (106 articles). For this task, the Methodologic Panel for BPH Guidelines was composed of multidisciplinary experts in the field.
The results of the study were summarized as follows:
For all that watchful waiting is an appropriate treatment strategyfor the majority of patients with prostatism, we couldn´t find the Korean literatures which carried this article. The literatures on alpha- l-adrenergic receptor blockers provide no evidence to suggest that any one alpha blocker is more effective than another. The finasteride reduces the size of the prostate, on average, and leads to a small yet perceptible reduction in sysptoms. of all treatment options, prostate surgery with transurethral re-section of the prostate (TURF), transurethral incision of the prostate (TUIP), and so on, offers the best chance for symptom improvement. However, surgery also has the highest rates of significant complications. Therefore, surgery need not always be a treatment of last resort. Balloon dilation of the prostatic urethra is dearly less effective than surgery in relieving symptoms, but it is associated with fewer complications. Emerging technologies for treating BPH include lasers, coils, stems, thermal therapy
and hyperthermia. Established technologies will also be reanalyzes) as results of new trials are reported.
Although this study has some limitations due to lacking for good quality literatures, it provides a cornerstone for our medical research. It represents they most current scien-
tific knowledge regarding the clinical epidemiology including treatment of BPH. It will be revised and updated as needed.
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KEYWORD
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Meta-analysis, Benign Prostatic Hyperplasia Treatment, Clinical Practice Guideline
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