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China Association of Traditional Chinese Medicine Male Urology Branch China Academy of Chinese Medical Sciences Xiyuan Hospital
Author profile: Guo Jun, guojun1126@126.com;
Funding: National Administration of Traditional Chinese Medicine’s TCM Inheritance and Innovation “Hundred, Thousand, Ten Thousand” Talent Project Qihuang Scholar Funding Project (Guo Zhongyi Ren Jiao Han [2022] No. 6);
Benign prostatic hyperplasia (BPH) is a common urological male disease causing voiding disorders in middle-aged and elderly men [1]. Studies show that the incidence of BPH in men over 60 years old is greater than 50%, reaching over 80% by age 80 [2]. BPH mainly manifests as histological proliferation of prostatic stroma and glandular components, anatomical enlargement of the prostate, urodynamic bladder outlet obstruction, and lower urinary tract symptoms (LUTS). Traditional Chinese Medicine (TCM) classifies this disease within the categories of “jing ling,” “ling bi,” and “lin zheng,” etc. [3].
Currently, clinical diagnosis and treatment of BPH face issues such as insufficient holistic disease management, non-standard treatment regimens, and unsatisfactory therapeutic effects. Clinical management involves multiple disciplines, including urology male medicine, TCM, acupuncture, rehabilitation, pelvic floor surgery, clinical pharmacy, and nursing. Multidisciplinary teams (MDT) involvement in diagnosis and treatment has certain advantages. Therefore, the Male Urology Branch of the China Association of Traditional Chinese Medicine organized experts in related fields, combining the latest domestic and international clinical evidence to formulate this guideline, aiming to provide reference for clinical physicians in multidisciplinary collaborative diagnosis and treatment of BPH and to maximize the role of MDT in BPH management.
I. Diagnosis and Assessment
Symptoms of BPH include storage phase, voiding phase, and post-voiding symptoms [4]. Storage symptoms include frequency, urgency, urinary incontinence, and nocturia; voiding symptoms include hesitancy, difficulty voiding, and intermittent urination; post-voiding symptoms include feeling of incomplete emptying and post-void dribbling. Men over age 50 who present primarily with LUTS should consider the possibility of BPH, conduct detailed history for initial assessment, and combine auxiliary tests to confirm diagnosis [5].
(1) Medical History Inquiry
(1) Patient’s general condition, such as development, nutrition, diet, sleep, etc.;
(2) Characteristics, duration, and associated symptoms of LUTS;
(3) Fluid intake: inquire about daily fluid intake and pre-sleep fluid intake;
(4) Past medical history: including diabetes, neurological diseases, and internal diseases possibly related to nocturia;
(5) Surgical history and trauma, especially pelvic surgery or trauma history;
(6) Medication history: understand whether the patient currently or recently took medications that may cause LUTS.
(2) Assessment Scales
Clinical recommendation to use symptom score questionnaires to help quantify LUTS and identify main symptoms [6,7].
(1) International Prostate Symptom Score (IPSS): currently the internationally recognized best scale to judge the severity of symptoms in BPH patients.
(2) Quality of Life (QOL) score: to understand patients’ perception of their current level of LUTS, focusing mainly on how much LUTS troubles and impacts the patient.
(3) International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICI-Q-LF): used to investigate the incidence of urinary incontinence and its impact.
(4) Overactive Bladder Syndrome Score (OABSS): to evaluate the severity of symptoms in overactive bladder syndrome patients.
(3) Physical Examination
(1) External genital examination: exclude diseases that might affect urination, such as meatal stenosis, phimosis, penile tumors, etc.
(2) Digital Rectal Examination (DRE): an important examination for BPH patients, to be done after bladder emptying. DRE can evaluate prostate size, shape, texture, presence of nodules or tenderness, whether the central sulcus is shallow or absent, and anal sphincter muscle tone. DRE is also an important method for prostate cancer screening [8].
(3) Local neurological examination (including motor and sensory): examining perianal and perineal peripheral nerves to suggest whether neurogenic bladder dysfunction caused by neurological diseases exists.
(4) Auxiliary Examination
1. Recommended Examinations
(1) Urinalysis: excluding hematuria, proteinuria, urinary tract infection in LUTS patients.
(2) Serum Prostate Specific Antigen (PSA): BPH, prostate cancer, and prostatitis can raise serum PSA. Additionally, measuring free PSA (fPSA) aids in early prostate cancer screening.
(3) Urinary system ultrasound: assessing prostate size, abnormal echoes, degree of bladder protrusion, residual urine volume, and if necessary, transrectal prostate ultrasound. Also evaluate kidneys and ureters for dilation, hydronephrosis, stones, or space-occupying lesions.
(4) Uroflowmetry: mainly includes maximum urinary flow rate (Qmax) and average urinary flow rate; maximum flow rate is more important. Test is more accurate with a urine volume over 150 mL; individual differences and volume dependence exist. Repeated testing increases reliability [9].
2. Optional Examinations
(1) Voiding diary: to differentiate increased frequency from excessive fluid intake, diabetes insipidus, nocturnal polyuria, and reduced bladder capacity [10].
(2) Creatinine: BPH causing bladder outlet obstruction can impair renal function leading to elevated creatinine. Recommend testing if renal insufficiency is suspected.
(3) Urodynamics: to assess the cause of bladder outlet obstruction and bladder function [11].
(4) Urethrocystoscopy: recommended if suspected urethral stricture or bladder space-occupying lesions in BPH patients.
MDT recommendations: (1) Urology male medicine: differentiate bladder outlet obstruction, prostate cancer, urethral stricture, neurogenic bladder dysfunction, and urinary tract infection. For chronic inflammation-induced bladder outlet obstruction, cystoscopy can help differentiate; prostate cancer is diagnosed via DRE, serum PSA, and prostate biopsy; urethral stricture through urethrography; neurogenic bladder by urodynamics; urinary tract infection via urinalysis and urine culture.
(2) Pelvic floor surgery: differentiate functional pelvic floor muscle spasm, pelvic floor relaxation syndrome, sphincter-detrusor dyssynergia, etc., and assess psychogenic factors causing abnormal voiding behavior. Collect pelvic floor muscle electromyography and surface electromyography for related examinations. Transperineal pelvic floor ultrasound can directly and dynamically observe pelvic floor organ activity for morphological and functional evaluation. MRI can more precisely and accurately detect pelvic floor and surrounding tissue structures.
(5) TCM Syndrome Differentiation
According to TCM, the fundamental pathogenesis is dysfunction of the Triple Burner, impaired bladder qi transformation, with lesions in the seminal chamber. Etiology is divided into excess and deficiency syndromes. Excess syndromes mainly include seminal chamber damp-heat, seminal chamber stasis obstruction, lung qi stagnation, and liver qi stagnation; deficiency syndromes include middle qi sinking, kidney yin deficiency, and spleen-kidney qi deficiency, especially closely related to kidney. Common syndrome types are as follows [12,13,14,15,16,17]:
(1) Seminal chamber damp-heat
Clinical manifestations: dribbling or frequent urination, urethral burning and pain, yellow-red urine, hypogastric distension or pain, bitter sticky taste with poor desire to drink, scrotal dampness. Tongue red with yellow greasy coating, wiry and rapid pulse.
(2) Seminal chamber stasis obstruction
Clinical manifestations: urinary dribbling or thread-like urine, sometimes complete dribbling cessation, turbid yellow urine, hypogastric stabbing pain. Tongue purple dark with stasis spots or stains, thin and dark coating, thin and choppy pulse. If accompanied by dampness, hypogastrium feels sore and distended, tongue coating thick and greasy.
(3) Lung qi stagnation
Clinical manifestations: difficulty urinating or dribbling, shortness of breath, coarse breath, occasional chest tightness or pain, emotional depression, thin tongue coating, wiry pulse.
(4) Liver qi stagnation
Clinical manifestations: emotional depression or irritability, difficult or unsmooth urination, hypochondriac and abdominal distension, discomfort or dull pain in the genital area, pale tongue, thin coating, wiry pulse.
(5) Middle qi deficiency
Clinical manifestations: hypogastric heaviness and distension, occasional urge to urinate but unable to void or scanty and unsmooth, fatigue, poor appetite, shortness of breath, reluctance to talk, low voice, or prolapse and anal prolapse, pale tongue with teeth marks on edges, thin white coating, thin and weak pulse. Spleen deficiency and kidney deficiency may accompany low back and knee soreness, dizziness, and tinnitus.
(6) Kidney qi instability
Clinical manifestations: frequent clear urination, post-urination dribbling, enuresis, nocturia, urinary incontinence, soreness and weakness of low back and knees, fatigue, tinnitus, premature ejaculation, pale tongue, white coating, weak pulse.
(7) Kidney yin deficiency
Clinical manifestations: scanty, yellow-red urine, frequent urination with difficulty, urethral burning, frequent nocturia, dry throat and irritability, malar flush in the afternoon, soreness and weakness of low back and knees, dizziness and tinnitus, red tongue with little coating, thin and rapid pulse.
(8) Spleen and kidney qi deficiency
Clinical manifestations: frequent urination, hesitancy, weak stream, difficulty urinating, inability to void, hypogastric heaviness and pain, poor appetite, fatigue, soreness and weakness of low back and knees, dizziness and tinnitus, pale tongue, thin white or slightly greasy coating, thin smooth and weak pulse.
(9) Kidney deficiency blood stasis
Clinical manifestations: difficult or frequent urination, mainly nocturia, clear urine, weak stream, shortening of urine stream, or involuntary urine leakage without control, often accompanied by pale face, lack of spirit, fear of cold, cold and sore low back and knees. Tongue dark red or with stasis spots and stains, white coating, sinking thin and choppy pulse.
MDT recommendation: According to TCM, this disease is mostly caused by improper diet, external dampness evil, emotional factors, and viscera deficiency. Syndromes are deficiency at the root with excess at the branch, common in elderly. Kidney qi transformation dysfunction causes qi and blood circulation issues and obstruction of fluid distribution, resulting in interlaced kidney deficiency, blood stasis, and damp turbidity, each causing and influencing the others. Thus, two or more syndrome types often co-exist clinically. Diagnosis and treatment should combine actual patient conditions, target etiology and pathogenesis, and focus on the “brain - heart - kidney - seminal chamber” axis. A holistic concept is important for BPH syndrome differentiation and treatment [18].
II. BPH Treatment Strategies
Treatment aims to improve symptoms and quality of life; short-term goal is to relieve LUTS; long-term goal is to delay clinical progression and prevent complications. Treatment principles focus on comprehensive therapy emphasizing harmonizing mind and body, and combining systemic and local treatment. Treatment options include lifestyle modification, watchful waiting, psychological and behavioral therapy, medication, acupuncture, surgery, and rehabilitation. Clinical decisions should integrate clinical evidence, physician experience, disease severity, and patient willingness to formulate specific treatment plans [19].
(1) Lifestyle Modification
Maintain good mood, avoid overwork; keep happy, participate in outdoor activities appropriately. Avoid stimulants such as caffeine or alcohol; guided by TCM theory, regulate emotions, with qigong and Dao Yin exercises to adjust breath, mind, and body; avoid external wind-cold illnesses to strengthen body and prevent disease.
(2) Watchful Waiting
For mild LUTS patients (IPSS ≤ 7) whose quality of life is not significantly affected, watchful waiting can be employed. Following TCM disease prevention concepts and patient willingness, combine TCM syndrome differentiation for early prevention and treatment, without strictly using scale scores to determine treatment timing.
MDT recommendations: (1) Urology male medicine: IPSS evaluation by urologist to decide if watchful waiting and related interventions are necessary. (2) TCM: early TCM therapy can relieve symptoms, improve quality of life, and delay progression. (3) Pelvic floor surgery: pelvic floor muscle exercises can strengthen pelvic muscles, restore normal tone to injured urethral sphincter, preventing urinary incontinence. Bladder training therapy can train patients to gradually extend voiding intervals and improve bladder compliance. Combining pelvic floor muscle exercise and bladder training has synergistic effects. (4) Psychiatry: psychological factors causing abnormal pelvic floor function affect treatment outcomes; thus, good psychological care is essential, with encouragement, support, and systematic regular guidance and follow-up to enhance adherence. TCM treatment should address local symptoms, overall condition, and mental state, paying attention to brain, mind, kidney qi in consideration of seminal chamber lesions. Treatment timing is not limited to IPSS score and must respect patient wishes; timely intervention can improve symptoms, quality of life, and delay disease progression.
(3) Pharmacological Treatment
1. Western Medicine Treatment
(1) α-adrenergic receptor blockers significantly improve symptoms, IPSS scores, and increase Qmax. Patients with prostate volume less than 40 mL have more obvious efficacy. Recommended for BPH patients with moderate to severe LUTS [20,21]. Recommended α-blockers include tamsulosin hydrochloride sustained-release capsules (Bitan), silodosin capsules (Qianweitai), etc.
(2) 5α-reductase inhibitors have a slower onset of action, recommended for BPH patients with enlarged prostate volume and moderate to severe LUTS [22,23].
(3) M receptor antagonists effectively reduce urination frequency, nocturia count, and IPSS score and reduce urgency urinary incontinence in patients with overactive bladder (OAB) without bladder outlet obstruction (BOO) [24].
(4) Phosphodiesterase type 5 inhibitors (PDE5i) reduce IPSS score, storage and voiding LUTS symptoms, and improve quality of life [24]. Recommended for BPH patients complicated with erectile dysfunction [25].
(5) β3 agonists have significant efficacy in treating OAB symptoms, reducing urination frequency, urgency, and urgency urinary incontinence occurrence. Both urination volume and nocturnal urine volume decrease distinctly [26]. Recommended for BPH patients combined with OAB.
MDT recommendations: (1) Urology male medicine: α-blockers act faster and are more advantageous in symptom improvement. 5α-reductase inhibitors act slower but reduce long-term (>1 year) risk of acute urinary retention and surgery. Combination of α-blockers and 5α-reductase inhibitors reduces clinical progression and has better efficacy in improving LUTS and Qmax. PDE5i combined with α-blockers or 5α-reductase inhibitors are suitable for BPH patients with erectile dysfunction. PDE5i plus finasteride can improve storage and voiding symptoms, quality of life, and erectile function.
(2) Clinical pharmacy: (1) Long-term above-standard dosage or continuous use of α-blockers may increase risk of ejaculation dysfunction; highly selective α-blockers more likely than less selective ones to cause this. Monitor blood pressure to avoid orthostatic hypotension during use. (2) Common side effects of 5α-reductase inhibitors include decreased libido, erectile dysfunction, and ejaculation disorders; consider these impacts when prescribing. (3) M receptor antagonists are not recommended for BOO patients due to theoretical reduction of bladder contractility causing increased post-void residual and urinary retention. Use cautiously and closely monitor IPSS and bladder residuals. (4) Adverse effects of PDE5i include flushing, gastroesophageal reflux, headache, indigestion, back pain, and nasal congestion. PDE5i should not be used with nitrates, potassium channel openers, or α-blockers doxazosin and terazosin. (5) The most common β3 agonist therapy-related adverse events are hypertension, urinary tract infection, headache, and nasopharyngitis. Contraindicated in patients with severely uncontrolled hypertension (systolic >180 mm Hg or diastolic >110 mm Hg, or both).
2. Traditional Chinese Medicine Treatment
(1) Seminal chamber damp-heat: principle - clear heat and remove dampness, promote seminal chamber patency. Prescription: Bazheng San (from Taiping Huimin Hejiju Fang), modified. Recommended patent medicine: Qianlexin capsules [27], oral, 4–6 capsules per dose, three times daily.
(2) Seminal chamber stasis obstruction: principle - move stasis and disperse knots, promote urination. Prescription: Dai Ditang Wan (from Zhengzhi Zhuncheng·Leifang), modified. Recommended patent medicines: Qianleshutong capsules [28], 3 capsules per dose, three times daily, oral; Guizhi Fuling capsules [29], 3 capsules per dose, three times daily, after meals.
(3) Lung qi stagnation: principle - open stagnation and descend qi, lift the lid. Prescription: Wumoyinzi (from Yifang Kao), modified.
(4) Liver qi stagnation: principle - soothe liver and regulate qi, promote urination. Prescription: Chenxiang San (from Weisheng Zongwei), modified. Recommended patent medicine: Chaihu Shugan Wan, oral, 1 pill per dose, twice daily with warm water.
(5) Middle qi deficiency: principle - raise clear and lower turbid, transform qi and promote water metabolism. Prescription: Buzhong Yiqi Tang (from Nei Wai Shang Bian Huo Lun) combined with Chunze Tang (from Yifang Jiejie), modified. Recommended patent medicine: Huangqi capsules [30], oral, 4 capsules per dose, three times daily.
(6) Spleen-kidney qi deficiency: principle - tonify spleen and qi, warm kidney and promote diuresis. Prescription: Si Junzi Tang (from Taiping Huimin Hejiju Fang), modified. Recommended patent medicines: Xia Liqi capsules [31], oral, 3 capsules per dose, three times daily; Qianleshule granules [32], dissolve in boiled water, one sachet per dose, three times daily.
(7) Kidney deficiency blood stasis: principle - warm and tonify kidney yang, promote qi circulation and remove blood stasis. Prescription: Qiantong Bibang [33]. Recommended patent medicine: Lingze tablets [34], oral, 4 tablets per dose, three times daily.
(8) Kidney yin deficiency: principle - nourish yin and tonify kidney, transform qi and promote water metabolism. Prescription: Zishen Tongguan Wan (from Lanshi Mancang) combined with Zhibai Dihuang Wan (from Yizong Jinjian), modified. Recommended patent medicine: Liuwei Dihuang Wan, oral, one large honey pill per dose, twice daily.
(9) Kidney qi instability: principle - tonify kidney and consolidate essence. Prescription: Jin Suo Gu Jing Wan (from Yifang Jiejie), modified. Recommended patent medicine: Qianleikang tablets [35], oral, 3–4 tablets per dose, three times daily. One month as one course.
(4) Other Treatments
1. Acupuncture Treatment
Acupuncture treatment for BPH features simple operation, relatively rapid effect, and high safety, and has a certain effect on relieving urinary retention and restoring bladder detrusor function [36]. Main acupoints include Zhongji (CV3), Guanyuan (CV4), Sanyinjiao (SP6), Zhibian (BL54) through Shuidao (ST28), and Yinlingquan (SP9) [37]. Additional points can be selected based on syndrome differentiation: for damp-heat accumulation, add Bladder Shu (BL28) and Hegu (LI4); for lung-heat obstruction, add Lung Shu (BL13) and Chize (LU5); for kidney yin deficiency, add Taixi (KI3) and Shenmen (HT7); for kidney yang deficiency, add Kidney Shu (BL23) and Mingmen (GV4); for spleen-kidney qi deficiency, add Spleen Shu (BL20) and Kidney Shu (BL23) [37].
Acupuncture operation: Guanyuan (CV4) and Sanyinjiao (SP6) are needled perpendicularly with lifting and thrusting reinforcing methods; Guanyuan may be combined with moxibustion; Zhongji (CV3) and Yinlingquan (SP9) are needled perpendicularly with lifting and thrusting reducing methods; Zhibian (BL54) utilizes lifting and thrusting reducing methods to penetrate Shuidao (ST28), with needle sensation radiating anteriorly toward the perineum; Kidney Shu (BL23) and Taixi (KI3) are needled perpendicularly with twisting reinforcing technique; Bladder Shu (BL28), Fenglong (ST40), Lung Shu (BL13), and Chize (LU5) are needled perpendicularly with twisting reducing techniques; Mingmen (GV4) is needled perpendicularly with twisting reinforcing technique; Kidney Shu (BL23) and Mingmen (GV4) can be combined with moxibustion; Spleen Shu (BL20) is needled perpendicularly with twisting reinforcing technique; needles are retained for 30 minutes, and electro-acupuncture can be applied. Acute urinary retention can be treated by acupuncture at Zhongji (CV3), Sanyinjiao (SP6), and Weiyang (BL39), with Zhongji needled horizontally and strong stimulation applied at Sanyinjiao and Weiyang points.
Moxibustion acts through its warming effect to promote blood circulation, remove blood stasis, and unblock the meridians, improving the local blood supply environment of the prostate, promoting blood flow, thereby effectively alleviating urinary tract obstruction, improving prostate symptoms, and eliminating urinary retention.
2. Herbal Preparations
This mainly refers to pollen-based preparations and plant extracts. Herbal preparations have nonspecific anti-inflammatory, anti-edema effects, promote bladder detrusor contraction, and relax urethral smooth muscle. The herbal preparation Sabal is recommended, composed of saw palmetto fruit extract. Sabal can significantly improve Qmax and IPSS in patients with BPH/LUTS and has long-term safety [38,39]. It can be used to treat early BPH patients with symptoms such as frequent urination, urgency, and difficulty urinating, administered orally, one capsule each time, twice daily.
3. Other Therapies
Traditional Chinese medicine (TCM) external treatments can relieve clinical symptoms. Studies report that therapies such as massage, acupoint application, acupoint embedding, and Chinese herbal enema can improve clinical symptoms of BPH [40,41,42,43], but further research is needed.
MDT recommendations: TCM department suggests that syndrome differentiation treatment and acupuncture can be used as first-line treatment methods for BPH, combined with other therapies [44]. Other traditional methods such as massage can also be applied during treatment and daily prevention. If the effect is poor after conventional treatment for more than 30 days, it is recommended to combine syndrome differentiation with acupuncture therapy.
(5) Surgical Treatment
Patients with moderate to severe LUTS significantly affecting quality of life may choose surgical or minimally invasive treatments, especially those with poor drug therapy response or who refuse drug treatment. Surgical methods should refer to relevant Western medicine clinical guidelines.
MDT recommendations: (1) Urology and Andrology department: Choice of surgical method should comprehensively consider physician experience, patient preferences, prostate volume, comorbidities and overall condition. Evaluation of treatment methods should consider efficacy, complications, and socioeconomic factors. Postoperative TCM intervention can accelerate recovery. (2) Acupuncture department: TCM acupuncture intervention can reduce occurrences of bladder spasms, bladder irrigation time, spasm duration, and clear time of irrigation fluid. (3) Rehabilitation department: Conservative rehabilitation usually includes health education, psychological counseling, and acupuncture treatment, effectively alleviating symptoms and improving quality of life [45]. Postoperative rehabilitation focuses on functional exercises and acupuncture. Postoperative urinary function training can effectively improve detrusor pressure, Qmax, and recovery rate of urination function, reduce IPSS scores, and relieve pain [46]. Pelvic floor muscle training can effectively reduce urinary incontinence incidence [47]. (4) Pelvic floor surgery department: Early postoperative pelvic floor muscle exercises effectively prevent urinary incontinence caused by sphincter weakness. Pelvic floor muscle bioelectric stimulation combined with acupuncture can improve post-TURP urination and sexual function, reduce incidences of postoperative urinary incontinence and erectile dysfunction, and improve overall quality of life. (5) Nursing specialty: Preoperative care: conduct assessments and guide patient pelvic floor muscle training; instruct effective cough and expectoration methods; give preoperative evening enema to prevent postoperative constipation. Postoperative care: (1) Monitor irrigation fluid temperature, speed, and drainage color, quality, and volume. (2) Ensure unobstructed catheter drainage; keep warm; maintain bladder irrigation fluid temperature around 37℃. (3) Observe for complications like TUR syndrome, urinary incontinence, and bleeding; guide the patient to gradually get out of bed and remain stool smooth to prevent bleeding due to increased intra-abdominal pressure during defecation. (4) Properly secure and keep drainage unobstructed; assess before catheter removal.
(6) BPH Follow-up
Follow-up generally includes the watchful waiting period, post-drug therapy, and post-surgical follow-up. Reexamination should be done 4–6 weeks after drug therapy initiation. If symptoms improve, drug therapy should continue. If symptoms do not worsen or absolute surgical indications are not present, follow-up should be every 6 months, then once yearly. Recommended follow-up items include medical history, IPSS, prostate size, urine flow rate, and residual urine volume. Patients receiving 5α-reductase inhibitors should be reviewed at 12 weeks and 6 months to evaluate drug response and adverse events, with regular follow-up and PSA testing.
Postoperative patients should monitor urination status, including hematuria, decreased urinary flow, urinary incontinence, and dysuria; patients with incontinence should be guided on pelvic floor function training; those discharged with drainage tubes should be instructed on proper tube care and observation of drainage turbidity and color. Post catheter removal, reexamination at 4–6 weeks should include IPSS, urine flow rate, and residual urine volume. If symptoms have improved without adverse events, further reassessment is unnecessary.
For patients after medical and surgical treatment, active health education should be conducted, including diet and lifestyle habits; exercise plans should be developed to encourage appropriate physical activity; and patients should be guided to build confidence in treatment and relieve anxiety.
3. Summary and Prospect
This guideline aims to assist physicians in making rational decisions on multidisciplinary diagnosis and treatment of BPH, providing effective evidence for multidisciplinary collaborative management. Some shortcomings remain, and the guideline cannot resolve all issues in BPH diagnosis and treatment. Clinical management should be tailored based on patient conditions, willingness, and available medical resources. With the development of multidisciplinary collaboration, more specialties will participate in guideline formulation and propose more comprehensive MDT recommendations, providing more comprehensive and scientific patient care. Meanwhile, this guideline will be continuously updated and improved based on advances in disciplines and clinical needs.
Advisors:
Song Chunsheng (China Academy of Chinese Medical Sciences Publishing House)
Dai Jican (Renji Hospital, Shanghai Jiao Tong University School of Medicine)
Shang Xuejun (Eastern Theater General Hospital)
Editorial board:
Guo Jun (Xiyuan Hospital, China Academy of Chinese Medical Sciences)
Jia Yusen (Dongfang Hospital, Beijing University of Chinese Medicine)
Sun Zixue (Henan Provincial Hospital of Traditional Chinese Medicine)
Ouyang Bin (First Affiliated Hospital, Tianjin University of Traditional Chinese Medicine)
Wu Tianlang (Affiliated Hospital, Chengdu University of Traditional Chinese Medicine)
Li Zhanmin (Affiliated Hospital, Liaoning University of Traditional Chinese Medicine)
Zhou Qing (First Affiliated Hospital, Hunan University of Traditional Chinese Medicine)
Chen Yun (Jiangsu Provincial Hospital of Traditional Chinese Medicine)
Wang Zengjun (Jiangsu Provincial People’s Hospital)
Deng Shumin (Beijing Hospital)
Zhang Chunhe (Yunnan Provincial Hospital of Traditional Chinese Medicine)
Zhang Chunying (Second Affiliated Hospital, Harbin Medical University)
Chen Lei (Longhua Hospital, Shanghai University of Traditional Chinese Medicine)
Bai Qiang (Xinhua Hospital, Shanghai Jiao Tong University School of Medicine)
Yuan Shaoying (Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine)
Wang Wanchun (Affiliated Hospital, Jiangxi University of Traditional Chinese Medicine)
Huang Xiaojun (Second Affiliated Hospital, Zhejiang University School of Medicine)
Yang Wentao (Ruikang Hospital, Guangxi University of Traditional Chinese Medicine)
Peng Yongjun (Jiangsu Provincial Hospital of Traditional Chinese Medicine)
Ding Liucheng (Jiangsu Provincial Hospital of Traditional Chinese Medicine)
Peng Yu (Yueyang Integrated Traditional Chinese and Western Medicine Hospital, Shanghai University of Traditional Chinese Medicine)
Dai Liqin (Jiangsu Provincial Hospital of Traditional Chinese Medicine)
Yu Xujun (Reproductive and Pediatric Hospital, Chengdu University of Traditional Chinese Medicine)
Geng Qiang (First Affiliated Hospital, Tianjin University of Traditional Chinese Medicine)
Han Qiang (Beijing Hospital of Traditional Chinese Medicine, Capital Medical University)
Wang Fu (Xiyuan Hospital, China Academy of Chinese Medical Sciences)
Wang Renyuan (Beijing Hospital of Traditional Chinese Medicine, Capital Medical University)
Gao Qinghe (Xiyuan Hospital, China Academy of Chinese Medical Sciences)
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