title: Management of lower urinary tract symptoms associated with benign prostatic hyperplasia in elderly patients with a new diagnostic, therapeutic and care pathway.
abstract: BACKGROUND
  Benign prostatic hyperplasia (BPH) resulting in lower urinary tract symptoms (LUTS) is a widespread disease that strongly interferes with the quality of life (QoL) of elderly males. It represents a real clinical and socio-economic problem may be due to the lack of a diagnostic, therapeutic and care pathway (DTCP) tool for LUTS/BPH that considers elderly people population in its whole complexity. The aim of this study was to evaluate the clinical effectiveness of the proposed DTCP LUTS/BPH tool.
  
  
  METHODS
  This prospective study was conducted on 278 patients over 75 years old with non-neurogenic LUTS recruited from February to July 2014 by 10 general practitioners (GP) and two assisted sanitary residences (ASR). Only five GPs and one ASR were provided with the complete DTCP LUTS/BPH tool to create two different groups of patients: group A (138 patients) was treated without the aid of the DTCP; group B (140 patients) was treated according to the DTCP.
  
  
  RESULTS
  At 1 year of follow-up, the patients of Group B compared with Group A achieved a greater and significant mean reduction in the questionnaires score (International Prostate Symptom Score, Quick prostate test and QoL) linked to a higher increase in the flowmetry parameters (Qmax) and a lower postvoid residual. Furthermore, in Group B compared to Group A, a greater improvement of hydronephrosis, creatinine values and erectile dysfunction (ED) were obtained at 1 year of follow-up.
  
  
  CONCLUSIONS
  The encouraging results obtained from this study are significant and support the use of this diagnostic, therapeutic and care tool (DTCP) as the ideal pathway management for elderly men with LUTS associated to BPH and ED. Further studies with greater number of elderly subjects and long-term follow-up are needed to confirm DTCP utility in the clinical management of LUTS/BPH and ED.
authors: Urology Unit, ICOT, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, "Sapienza" University of Rome, Latina, Italy.|Uroresearch, No Profit Research Investigation in Urology, Latina, Italy.
authors: Antonio
authors: A
authors: Carbone
authors: Urology Unit, ICOT, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, "Sapienza" University of Rome, Latina, Italy.
authors: Andrea
authors: A
authors: Fuschi
authors: Urolgy Unit, Department of Special Surgery, Faculty of Medicine, Mutah University, Karak, Jordan.
authors: Samer Fathi
authors: SF
authors: Al Rawashdah
authors: Urology Unit, ICOT, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, "Sapienza" University of Rome, Latina, Italy.
authors: Yazan
authors: Y
authors: Al Salhi
authors: Urology Unit, ICOT, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, "Sapienza" University of Rome, Latina, Italy.
authors: Gennaro
authors: G
authors: Velotti
authors: Urology Unit, ICOT, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, "Sapienza" University of Rome, Latina, Italy.
authors: Andrea
authors: A
authors: Ripoli
authors: Urology Unit, ICOT, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, "Sapienza" University of Rome, Latina, Italy.
authors: Domenico
authors: D
authors: Autieri
authors: Urology Unit, ICOT, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, "Sapienza" University of Rome, Latina, Italy.|Uroresearch, No Profit Research Investigation in Urology, Latina, Italy.
authors: Giovanni
authors: G
authors: Palleschi
authors: Urology Unit, ICOT, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, "Sapienza" University of Rome, Latina, Italy. antopast@hotmail.com.|Uroresearch, No Profit Research Investigation in Urology, Latina, Italy. antopast@hotmail.com.
authors: Antonio Luigi
authors: AL
authors: Pastore
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000359:Aftercare; D000368:Aged; D003131:Combined Modality Therapy; D019091:Critical Pathways; D003950:Diagnostic Techniques, Urological; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D008297:Male; D026741:Physical Therapy Modalities; D011470:Prostatic Hyperplasia / Q000150:complications*; D040242:Risk Reduction Behavior; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D014563:Urodynamics / Q000502:physiology
chemical_list: D000317:Adrenergic alpha-Antagonists