精准医学在诊断和治疗提示良性前列腺增生的男性下尿路症状中的应用。

Ci ji yi xue za zhi = Tzu-chi medical journal Pub Date : 2019-08-21 eCollection Date: 2020-01-01 DOI:10.4103/tcmj.tcmj_107_19
Jing-Liang Chen, Yuan-Hong Jiang, Cheng-Ling Lee, Hann-Chorng Kuo
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摘要

男性下尿路症状(LUTS)在男性中发病率很高,而且发病率随着年龄的增长而增加。男性下尿路症状的病理生理学可能是膀胱出口功能障碍,如膀胱颈(BN)功能障碍、良性前列腺梗阻、外括约肌松弛不良和膀胱功能障碍,如逼尿肌过度活动(DO)、逼尿肌活动不足、DO和收缩力不足。男性尿失禁包括排尿和储尿症状,因此不能仅根据症状进行精确诊断。视频尿动力学检查可以全面观察膀胱和膀胱出口,当初始药物治疗无法缓解 LUTS 时,视频尿动力学检查可以清楚地显示潜在的病理生理学。应根据 LUTS 的潜在病理生理学进行药物治疗,只有在有创尿路动力学检查证实前列腺阻塞导致膀胱出口梗阻时,才应进行手术干预,切除前列腺。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Precision medicine in the diagnosis and treatment of male lower urinary tract symptoms suggestive of benign prostatic hyperplasia.

Male lower urinary tract symptoms (LUTSs) are highly prevalent in men and the incidence increases with aging. The pathophysiology of male LUTSs might be bladder outlet dysfunctions such as bladder neck (BN) dysfunction, benign prostatic obstruction, and poor relaxation of external sphincter and bladder dysfunctions such as detrusor overactivity (DO), detrusor underactivity, DO, and inadequate contractility. Male LUTSs include voiding and storage symptoms, and precision diagnosis should not be done based on the symptoms alone. Videourodynamic study provides a thorough look at the bladder and bladder outlet and can clearly demonstrate the underlying pathophysiology when the initial medication fails to relieve LUTS. Medical treatment should be given based on the underlying pathophysiology of LUTS, and surgical intervention to remove prostate should only be performed when a definite bladder outlet obstruction due to prostatic obstruction has been confirmed by invasive urodynamic study.

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