Background and Purpose
The incidence of benign prostatic hyperplasia is rapidly increasing along with the aging population. In addition, as the public’s desire to improve the quality of life increases, interest in treatment methods for prostatic hyperplasia is also increasing. According to the Health Insurance Review and Assessment Service, the number of patients with benign prostatic hyperplasia in Korea showed an overall trend of increasing every year, from 967,145 in 2013 to 1,426,279 in 2022. The total cost of nursing care benefits also showed a tendency to increase every year from 11,749,351,000 won in 2013 to 321,367,595,000 won in 2022. Through this, it can be seen that medical costs also increase as the prevalence of benign prostatic hyperplasia increases, which can act as an economic burden on individuals and society. Considering the above points, there is an urgent need for early diagnosis and evidence-based treatment of benign prostatic hyperplasia. In addition, there is a need for clinical practice guidelines that can be accepted in clinical settings in Korean medicine treatment for benign prostatic hyperplasia. However, since no guidelines for Korean medicine treatment have been produced to date, the treatment methods of frontline Korean medicine doctors are not unified, and evaluation of results is also difficult.
Therefore, this clinical practice guideline is necessary to suggest an efficient treatment direction so that Korean medicine doctors can smoothly apply it to clinical practice when encountering patients with benign prostatic hyperplasia in clinical settings.
Overview of disease
Benign prostatic hyperplasia (KCD code; N40.0, N40.1, N40.2, N40.3, N40.8) is characterized by lower urinary tract symptoms such as residual urine sensation, urinary urgency, weak urine, abdominal pressure, and delayed urine in elderly men. It is a major disease that causes lower urinary tract symptoms(LUTS).
Currently, the definition of benign prostatic hyperplasia is not clearly established, and in practice, benign prostatic hyperplasia is diagnosed through a combination of prostate enlargement, obstruction, and lower urinary tract symptoms.
① Histological definition: Proliferation of prostatic stroma and epithelial cells (Benign prostatic hyperplasia: BPH)
② Urodynamic definition: A condition in which an increase in intravesical pressure and a decrease in urination rate occur simultaneously due to bladder outlet obstruction (BOO).
③ Radiological definition: Benign prostate enlargement (BPE)
④ Clinical definition: Cases complaining of lower urinary tract symptoms due to bladder outlet obstruction (BPO) accompanied by an increase in the size of the prostate.
In classical Korean medicine literature, the terms benign prostatic hyperplasia do not exist. However, considering the pathophysiology and clinical symptoms of benign prostatic hyperplasia, benign prostatic hyperplasia falls into categories such as “Yung-pye(癃閉)” and “Im-jeung(淋證)” Bladder irritation symptoms (frequent urination, enuresis, etc.) that appear due to prostatic hyperplasia are interpreted as “Im-jeung(淋證)”, and obstruction symptoms (delayed urination, urination, post-micturition dripping, etc.) are interpreted in the category of “Yung-pye(癃閉)”.
