男性膀胱出口梗阻诊断的最新进展。

Bladder (San Francisco, Calif.) Pub Date : 2024-11-21 eCollection Date: 2024-01-01 DOI:10.14440/bladder.2024.0022
Ruoyu Li, Yuancheng Zhou, Xingyuan Xiao, Bing Li
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引用次数: 0

摘要

背景:膀胱出口梗阻(BOO)是男性下尿路症状的常见原因,通常由良性前列腺增生引起。主要症状包括梗阻性和刺激性尿路症状,如排尿困难、排尿频率增加和尿急,以及反复尿路感染。BOO还可引起上尿路扩张(肾积水)、结构损伤和膀胱功能损害。目的:早期诊断BOO对保护肾脏和膀胱功能至关重要。诊断BOO的金标准是尿动力学研究(UDS),它测量逼尿肌压力和尿流量。然而,UDS是一种侵入性检查,与尿路感染、恼人的泌尿系统症状和血尿的风险有关。考虑到UDS的侵入性和不适,非侵入性诊断方法已经被开发出来。然而,这些技术的主要限制是阈值的可变性,强调了进一步标准化测量方案的必要性。本文回顾了目前男性BOO的诊断方法,并探讨了它们的临床应用。结论:多种无创诊断方法具有广阔的应用前景;然而,UDS仍然是主要的诊断方法。
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Recent advances in the diagnosis of bladder outlet obstruction in men.

Background: Bladder outlet obstruction (BOO) represents a common cause of lower urinary tract symptoms in men, frequently resulting from benign prostatic hyperplasia. Key symptoms include both obstructive and irritative urinary tract symptoms, such as dysuria, increased frequency and urgency of urination, and recurrent urinary tract infections. BOO can also cause upper urinary tract dilation (hydronephrosis), damage structure, and impair function of the bladder.

Objective: Early diagnosis of BOO is essential to the protection of kidney and bladder functions. The gold standard for diagnosing BOO is urodynamic studies (UDS), which measure detrusor pressure and urinary flow. However, UDS is an invasive test and is associated with risks for urinary tract infections, bothersome urinary symptoms, and hematuria. Given the invasiveness and discomfort associated with UDS, non-invasive diagnostic methods have been developed. Nevertheless, the main limitation of these techniques is the variability in threshold values, highlighting the need for further standardization of measurement protocols. This article reviews the current diagnostic approaches for BOO in men and explores their clinical utility.

Conclusion: Various non-invasive diagnostic methods are promising; yet, UDS remains the primary diagnostic approach.

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