Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH): AUA Guideline amendment 2023 Guidelines


Authors: Sandhu, J. S.; Bixler, B. R.; Dahm, P.; Goueli, R.; Kirkby, E.; Stoffel, J. T.; Wilt, T. J.
Title: Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH): AUA Guideline amendment 2023
Abstract: Purpose: The purpose of this American Urological Association (AUA) Guideline amendment is to provide a useful reference on the effective evidence-based management of male lower urinary tract symptoms secondary/attributed to BPH (LUTS/BPH). Materials and Methods: The Minnesota Evidence Review Team searched Ovid MEDLINE, the Cochrane Library, and the Agency for Healthcare Research and Quality (AHRQ) database to identify studies relevant to the management of BPH. The guideline was updated in 2023 to capture eligible literature published between September 2020 and October 2022. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions. Results: The BPH amendment resulted in changes to statements/supporting text on combination therapy, photoselective vaporization of the prostate (PVP), water vapor thermal therapy (WVTT), laser enucleation, and prostate artery embolization (PAE). A new statement on temporary implanted prostatic devices (TIPD) was added. In addition, statements on transurethral needle ablation (TUNA) and transurethral microwave thermotherapy (TUMT) were removed and information regarding these legacy technologies was added to the background section. References and the accompanying treatment algorithms were updated to align with the updated text. Conclusion: This guideline seeks to improve clinicians' ability to evaluate and treat patients with BPH/LUTS based on currently available evidence. Future studies will be essential to further support these statements to improve patient care. © 2024 Lippincott Williams and Wilkins. All rights reserved.
Keywords: treatment outcome; prostate; prostate hypertrophy; prostatic hyperplasia; transurethral resection; prostate surgery; laser therapy; transurethral resection of prostate; complication; lower urinary tract symptom; procedures; ipss; luts; turp; lower urinary tract symptoms; bph; humans; human; male; alpha blocker; anticholinergic; holep; laser enucleation; mist; pvp; thulep; water vapor thermal therapy
Journal Title: Journal of Urology
Volume: 211
Issue: 1
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2024-01-01
Start Page: 11
End Page: 19
Language: English
DOI: 10.1097/ju.0000000000003698
PUBMED: 37706750
PROVIDER: scopus
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Jaspreet Sandhu
    138 Sandhu