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Kontroversen in der konservativen und operativen BPS-Therapie

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Benignes Prostatasyndrom

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Zusammenfassung

Anstoß zur Erstellung dieses Kapitels gab die Übersichtsarbeit „Hartnäckige Mythen zum Thema BPS – und was davon wirklich stimmt!“ von Prof. Dr. Matthias Oelke und Kollegen, aus der dieses Kapitel zu großen Teilen besteht und deren Autoren wir zu großem Dank verpflichtet sind (Oelke M et al. 2019). Diese Arbeit befasst sich inhaltlich mit gängigen „Lehr- und Expertenmeinungen“, die seit Jahrzehnten durch die konservative und operative BPS-Therapie geistern und schwer aus den Köpfen zu bekommen sind (Level of Evidence 5). Über die hartnäckige Verbreitung dieser Meinungen des „Warum?“ kann man nur spekulieren, da eine Diskrepanz zwischen volkswirtschaftlicher Bedeutung und Evidenz besteht: Das BPS ist in den westlichen Industrienationen die häufigste urologische Erkrankung, die vierthäufigste sowie fünftteuerste Erkrankung bei Männern ≥50 Jahre. Etwa 5 Mio. deutsche Männer sind vom BPS betroffen, von denen sich etwa die Hälfte in ärztlicher Behandlung befindet (Berges RR et al. 2001). Bei durchschnittlichen Kosten für Diagnostik und Therapie von ca. € 900 pro BPS-Patient/Jahr muss das deutsche Gesundheitssystem ca. € 2,2 Mrd./Jahr für das BPS aufwenden (Van Exel NJ et al. 2006). Die steigende Prävalenz des BPS aufgrund des zunehmenden Lebensalters der männlichen Bevölkerung Deutschlands unterstreicht zusätzlich die Bedeutung des BPS.

Aufgrund der epidemiologischen Daten und somit der volkswirtschaftlichen Bedeutung liegt eine wissenschaftliche Fokussierung auf das BPS nahe. Leider ist das Gegenteil der Fall: eine Fokussierung der (deutschen) Urologie auf onkologische Themen. Die Ursachen dafür sind (gesundheitspolitisch) vielschichtig und führen über den Inhalt des Buches hinaus. Zusammenfassend wird das BPS aktuell wissenschaftlich unterrepräsentiert, während BPS-Patienten klinisch überrepräsentiert sind. Möglichweise führt diese Diskrepanz zu dem hartnäckigen Festhalten an „Lehr- und Expertenmeinungen“…auch, wenn diese These schwer zu beweisen ist.

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    Christopher Netsch & Andreas J. Gross

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Netsch, C., Gross, A.J. (2022). Kontroversen in der konservativen und operativen BPS-Therapie. In: Netsch, C., Gross, A.J. (eds) Benignes Prostatasyndrom. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-64334-1_23

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