The last several years have seen an explosion of new information and strategies for managing BPH; many more advances lie on the horizon. It’s tough for anyone—including doctors—to assimilate the sometimes confusing, often conflicting reports of the latest innovations in treating BPH.
So what are you supposed to do? When you read about a breakthrough in the newspaper or hear about it from a friend, how should you evaluate it?
Here are some basic principles:
Beware of the Placebo Effect. This is the first “grain of salt” to take into consideration in any study. Researchers are always wary of the placebo effect, an inexplicable improvement in the so-called “control” group who are taking “sugar pills,” which they believe to be real medication. In almost every study of a drug or treatment for any disease, there is some improvement in the control group. This phenomenon is almost always attributable to a boost in mental health that comes from taking part in a study, or from the belief that some new medication is making a real difference in symptoms. (However, it also reminds us never to underestimate the powerful effect of a positive attitude on physical symptoms!)
With BPH, there is a tremendous placebo effect to any form of treatment. In one series of studies that included a placebo group, 30 percent to 75 percent of placebo-treated men reported subjective improvement in their urinary symptoms—this means that they believed their symptoms were better—and as many as 15 percent to 20 percent reported significant improvement in urinary flow rates.
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