A stydy of standarization of criteria for severity and treatment efficacy in Benign Prostate hyperplasia (BPH)

本研究旨在建立良性前列腺增生（Benign Prostate hyperplasia， BPH）的严重程度和治疗效果的标准，以统一最佳的治疗适应证，并在同一水平上评价不同治疗方式的治疗效果。为此，组建了从病理学到泌尿外科的优秀研究人员组成的课题组。为了建立标准标准，我们收集了来自10家机构的BPH患者的临床资料作为合作研究。数据由症状（国际前列腺症状评分；I-PSS）、生活质量（生活质量评分I-PSS）、功能（最大流量、Qmax和残尿；RU）和解剖（前列腺体积；PV）以及各机构主治医生对严重性和疗效评估的评价组成，分为5个等级。根据这些数据，每个域的严重程度标准分为轻度、中度和重度3个等级。根据评估的每个领域中等级的数量，一般严重性也分为3个等级。根据各领域治疗前后的差异，将治疗疗效标准分为优秀、良好、一般、差/差4类。PV被排除在治疗效果的标准之外，因为一些治疗方式会使前列腺体积缩小。本标准对BPH严重程度和治疗效果的临床有效性将通过前瞻性研究进行评估，并在未来进行修订，以适应BPH的实际应用和临床试验。

The objectives of this research are to establish the standard criteria for severity and treatment efficacy in Benign Prostate hyperplasia (BPH) which will contribute to harmonize the optimum treatment indication, and to evaluate the treatment efficacy to the various modalities of treatment standing on the same levels. For this purpose, the research group was organized including the outstanding researchers from pathologist to urology. To establish the standard criteria, clinical data of BPH patients were accumulated from 10 institutions as a collaborate study. The date were constituted of symptom (internatoinal prostate symptom score ; I-PSS), QOL (QOL scorein I-PSS), function (Maximum flow rate ; Qmax and residual urine ; RU) and anatomy (prostate volume ; PV) as well as the evaluations in sererity and efficacy evaluations into 5 grades by attending doctors of each institution. The severity criteria of each domain is classified into 3 grades, mild, moderate and severe depending upon these data. The general severity is also classified into 3 grades depending on the number of the grade in each domain evaluated. The criteria of treatment efficacy was classified into 4 categories, excellent, good fair, poor/worse depending on the difference between pre-and post- treatment in each domain. The PV was excluded form the criteria of treatment efficacy because some treatment modalities are subjecting the volume reduction of the prostate.The clinical usefulness of this standard criteria for severity and treatment efficacy in BPH will be evaluated through prospective study, and revised in future to adapt in practical use and clinical trials on BPH.