Guide dedicated to general practitioner for the management of lower urinary tract symptoms related to benign prostatic hyperplasia

被引：10

作者：

Descazeaud, A. ^{[1
]}

Delongchamps, N. Barry ^{[2
,3
]}

Cornu, J. -N. ^{[4
]}

Azzouzi, A. R. ^{[5
]}

Buchon, D. ^{[6
]}

Benchikh, A.

Coloby, P. ^{[7
]}

Dumonceau, O. ^{[8
]}

Fourmarier, M. ^{[9
]}

Haillot, O. ^{[10
]}

Lebdai, S. ^{[5
]}

Mathieu, R. ^{[11
]}

Misrai, V. ^{[12
]}

Saussine, C. ^{[13
]}

de La Taille, A. ^{[14
]}

Robert, G. ^{[15
]}

机构：

[1] CHU Limoges, Hop Dupuytren, Serv Chirurg Urol, F-87042 Limoges, France

[2] CHU Cochin, Assistance Publ Hop Paris, Serv Urol, F-75014 Paris, France

[3] Inst Necker Enfants Malades, INSERM, U1151, F-75015 Paris, France

[4] Univ Paris 06, Hop Tenon, Assistance Publ Hop Paris, Serv Urol, F-75020 Paris, France

[5] CHU Angers, Serv Urol, F-49933 Angers, France

[6] Univ Limoges, Fac Med, Dept Med Gen, F-87000 Limoges, France

[7] Ctr Hosp Rene Dubos, Serv Urol, F-95300 Pontoise, France

[8] Clin Turin, Serv Urol, F-75008 Paris, France

[9] Ctr Hosp Aix En Provence, Serv Urol, F-13616 Aix En Provence, France

[10] CHU Tours, Serv Urol, F-37000 Tours, France

[11] CHU Rennes, Hop Pontchaillou, Serv Urol, F-35000 Rennes, France

[12] Clin Pasteur, Serv Urol, F-31300 Toulouse, France

[13] CHU Strasbourg, Serv Urol, F-67000 Strasbourg, France

[14] CHU Henri Mondor, Assistance Publ Hop Paris, Serv Urol, F-94000 Creteil, France

[15] Univ Bordeaux, CHU Bordeaux, Serv Urol, F-33000 Bordeaux, France

来源：

PROGRES EN UROLOGIE | 2015年 / 25卷 / 07期

关键词：

Benign prostatic hyperplasia; Lower urinary tract symptoms; General practitioners; OF-THE-LITERATURE; LUTS COMMITTEE; SURGICAL-MANAGEMENT; DOUBLE-BLIND; FOLLOW-UP; MEN; FINASTERIDE; TAMSULOSIN; THERAPY; TERMINOLOGY;

D O I：

10.1016/j.purol.2015.02.008

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Objective. To establish a guide dedicated to general practitioner for the diagnosis, the followup, and the treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH). Method. Guidelines already published for urologists were modified to make them relevant for general practitioners. The role of specialist's referral was defined. The whole content of the document was submitted to the formal consensus process in which urologists and general medicine teachers were involved. Results. Initial assessment has several aims: making sure that LUTS are related to BPH, assessing bother related to LUTS, and checking for a possible complication. Initial assessment should include: medical history, physical examination with digital rectal examination, and urinalysis. Some other explorations such as frequency volume chart, serum PSA or creatinine, and ultrasonography of the urinary tract were found optional, meaning they are necessary only in specific situations. Referring to urologist is justified when LUTS might not be related to BPH (particularly when urgencies are predominant), or when a severe bladder outlet obstruction is suspected (severe symptoms, palpable bladder, post-voiding residual volume > 100 ml), or when a complication is assessed. Follow-up without treatment is justified for patients with no bothersome symptoms related to not complicated BPH. Several drugs are available for the treatment of bothersome symptoms related to BPH. Alpha-blockers and plants extracts might be offered as monotherapy. Five alpha reductase inhibitors might be offered to patients with LUTS related to a significant prostate hypertrophy (>40 ml); they might be given for a minimum duration of one year, alone or in association with alpha-blocker. The association of antimuscarinic and alpha-blocker might be used in patients with persistent storage LUTS in spite of alpha-blocker treatment. Phosphodiesterase 5 inhibitors might be offered to patients with erectile dysfunction associated with LUTS related to BPH. In case of complicated BPH, or when medical treatment is not efficacious or not tolerated, a surgical option should be discussed. Conclusion. The male lower urinary tract symptom committee of the French Urological Association and general practitioner present the first guide for the management of LUTS related to BPH dedicated to general practitioner. (C) 2015 Elsevier Masson SAS. All rights reserved.

引用

页码：404 / 412

页数：9

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