BPH Guidelines evolution from 2001 to 2012. Where do we come from and where are we going.

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GUÍAS PARA HBP: ¿DE DONDE VENIMOS Y DONDE VAMOS? Eduard García Cruz [email protected] @drgarciacruz www.reisho.com Eduard García Cruz Urología y Salud del Hombre Servicio de Urología Barnaclínic Hospital Clínic de Barcelona [email protected] @drgarciacruz www.reisho.com Conflict of interest: he recibido fondos para investigación de BAYER, Lilly, Pfizer, Olympus, Auxilium y Janssen, he formado parte de comités asesores para Bayer, Lilly, Janssen, Gebro, Italpharmaco and Menarini y soy ponente para Lilly, GSK y Bayer.

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Evolution on European Guidelines on BPH from 2001 to 2012, stressing in the importance of the risk of progression in the managing of prostate issues.

Transcript of BPH Guidelines evolution from 2001 to 2012. Where do we come from and where are we going.

Page 1: BPH Guidelines evolution from 2001 to 2012. Where do we come from and where are we going.

GUÍAS PARA HBP:¿DE DONDE VENIMOS

Y DONDE VAMOS?

Eduard García [email protected]

@drgarciacruzwww.reisho.com

Eduard García CruzUrología y Salud del Hombre

Servicio de UrologíaBarnaclínic

Hospital Clínic de [email protected]

@drgarciacruzwww.reisho.com

Conflict of interest: he recibido fondos para investigación de BAYER, Lilly, Pfizer, Olympus, Auxilium y Janssen, he formado parte de comités asesores para Bayer, Lilly, Janssen, Gebro, Italpharmaco and Menarini y soy ponente para Lilly, GSK y Bayer.

mailto:[email protected]
mailto:[email protected]
Page 2: BPH Guidelines evolution from 2001 to 2012. Where do we come from and where are we going.

“Tempus irreparabile fugit” Virgilio

Page 3: BPH Guidelines evolution from 2001 to 2012. Where do we come from and where are we going.

“Tempus irreparabile fugit” Virgilio

Page 4: BPH Guidelines evolution from 2001 to 2012. Where do we come from and where are we going.

¿CÓMO HAN EVOLUCIONADO LAS GUIDELINES EN HBP RESPECTO…

1. AL DIAGNÓSTICO?

2. AL TRATAMIENTO MÉDICO?

3. AL TRATAMIENTO QUIRÚRGICO?

Page 5: BPH Guidelines evolution from 2001 to 2012. Where do we come from and where are we going.

¿CÓMO HAN EVOLUCIONADO LAS GUIDELINES EN HBP RESPECTO…

1. AL DIAGNÓSTICO?

2. AL TRATAMIENTO MÉDICO?

3. AL TRATAMIENTO QUIRÚRGICO?

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RIESGO DE PROGRESIÓN

Próstata >30ccPSA >1,5

Qmax <10ml/segRPM >40ml

Page 11: BPH Guidelines evolution from 2001 to 2012. Where do we come from and where are we going.

¿CÓMO HAN EVOLUCIONADO LAS GUIDELINES EN HBP RESPECTO…

1. AL DIAGNÓSTICO?

2. AL TRATAMIENTO MÉDICO?

3. AL TRATAMIENTO QUIRÚRGICO?

Page 12: BPH Guidelines evolution from 2001 to 2012. Where do we come from and where are we going.

¿CÓMO HAN EVOLUCIONADO LAS GUIDELINES EN HBP RESPECTO…

1. AL DIAGNÓSTICO?

2. AL TRATAMIENTO MÉDICO?

3. AL TRATAMIENTO QUIRÚRGICO?

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FITOTERAPIA ALFA-BLOQUEANTE

S

5-ARI COMBO WW

= 5-ARI Beneficios sostenidos

Finasteride> 40cc

No IPSS<7

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Page 16: BPH Guidelines evolution from 2001 to 2012. Where do we come from and where are we going.

FITOTERAPIA ALFA-BLOQUEANTE

S

5-ARI COMBO WW

= 5-ARI Beneficios sostenidos

Finasteride> 40cc

No IPSS <7

DesconocidoBeneficios sostenidos.

Finasteride (>40cc) y

dutasteride, alteran Hª

natural HBP.No alt PCa

Si IPSS <15

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Page 18: BPH Guidelines evolution from 2001 to 2012. Where do we come from and where are we going.

FITOTERAPIA ALFA-BLOQUEANTE

S

5-ARI COMBO WW

= 5-ARI Beneficios sostenidos

Finasteride> 40cc

No IPSS <7

DesconocidoBeneficios sostenidos.

Finasteride (>40cc) y

dutasteride, alteran Hª

natural HBP.No alt PCa

Si IPSS <15

No se puede concluir

IPSS >7 Finasteride

(>40cc) y dutasteride alteran Hª

natural.

Si IPSS <7

* *

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Hombres >50 añosPróstata >30cc

PSA >1,5IPSS >12

>4.800 hombres

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RIESGO DE PROGRESIÓN

Próstata >30ccPSA >1,5

Qmax <10ml/segRPM >40ml

Page 23: BPH Guidelines evolution from 2001 to 2012. Where do we come from and where are we going.

¿CÓMO HAN EVOLUCIONADO LAS GUIDELINES EN HBP RESPECTO…

1. AL DIAGNÓSTICO?

2. AL TRATAMIENTO MÉDICO?

3. AL TRATAMIENTO QUIRÚRGICO?

Page 24: BPH Guidelines evolution from 2001 to 2012. Where do we come from and where are we going.

¿CÓMO HAN EVOLUCIONADO LAS GUIDELINES EN HBP RESPECTO…

1. AL DIAGNÓSTICO?

2. AL TRATAMIENTO MÉDICO?

3. AL TRATAMIENTO QUIRÚRGICO?

Page 25: BPH Guidelines evolution from 2001 to 2012. Where do we come from and where are we going.
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Estratificar por riesgo de progresión.

Analizar síntomas (nocturia, inversión de diuresis, OAB, esfera sexual).

Combinación en hombres con riesgo de progresión.

Desde el punto de vista quirúrgico, múltiples opciones. HoLEP comparable a prostatectomía .

Page 30: BPH Guidelines evolution from 2001 to 2012. Where do we come from and where are we going.

“Tempus irreparabile fugit” Virgilio

Page 31: BPH Guidelines evolution from 2001 to 2012. Where do we come from and where are we going.

GUÍAS PARA HBP:¿DE DONDE VENIMOS

Y DONDE VAMOS?

Eduard García [email protected]

@drgarciacruzwww.reisho.com

Eduard García CruzUrología y Salud del Hombre

Servicio de UrologíaBarnaclínic

Hospital Clínic de [email protected]

@drgarciacruzwww.reisho.com

Conflict of interest: he recibido fondos para investigación de BAYER, Lilly, Pfizer, Olympus, Auxilium y Janssen, he formado parte de comités asesores para Bayer, Lilly, Janssen, Gebro, Italpharmaco and Menarini y soy ponente para Lilly, GSK y Bayer.

mailto:[email protected]
mailto:[email protected]
Page 32: BPH Guidelines evolution from 2001 to 2012. Where do we come from and where are we going.

Informe Bph

Informe Bph

CHF, CRF, BPH

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IncreasedInfiltratedMacrophagesinBenignProstatic Hyperplasia(BPH) · PDF file · 2012-10-11IncreasedInfiltratedMacrophagesinBenignProstatic Hyperplasia(BPH) ... associated with lower

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THERE’S WORK TO DO.6'' Augers 1,200-1,400 BPH 8'' Augers 2,100-2,400 BPH 10'' Augers 3,200-3,600 BPH 12'' Augers 5,000-5,400 BPH 14'' Augers 10,000-11,000 BPH TD-450

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