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Hiperplasia prostática benigna

Последний просмотренный: 20 Aug 2025
Last updated: 06 Sep 2024

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • presença de fatores de risco
  • sintomas de armazenamento
  • sintomas de micção
Полная информация

Другие диагностические факторы

  • febre com disúria
  • retenção urinária
Полная информация

Факторы риска

  • idade superior a 50 anos
  • história familiar de HPB
  • raça não asiática
  • tabagismo
  • alopécia androgênica
  • síndrome metabólica
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • urinálise
  • antígeno prostático específico (PSA)
  • questionário de escore de sintomas
  • quadro de frequência/volume e diário de micção
Полная информация

Исследования, проведение которых нужно рассмотреть

  • ultrassonografia
  • TC ou RNM do abdome/pelve
  • cistoscopia
  • Avaliação do resíduo pós-miccional (RPM)
  • urofluxometria
  • estudos urodinâmicos de pressão de fluxo
  • avaliação da função renal
Полная информация

Алгоритм лечения

Острый

sintomas não incômodos

sintomas incômodos sem indicação de cirurgia

sintomas incômodos com indicação de cirurgia: volume da próstata ≤30 g

sintomas incômodos com indicação de cirurgia: volume da próstata 30-80 g

sintomas incômodos com indicação de cirurgia: volume da próstata ≤80 g

Составители

Авторы

Claus Roehrborn, MD

Professor

Urology

University of Texas Southwestern Medical Center

Dallas

TX

Раскрытие информации

CR is on an ad board for Teleflex; consults for Teleflex, Zenflow, and Medeon; and has done research with Zenflow and Teleflex. CR is an author of several references cited in this topic.

Ramy Goueli, MD

Assistant Professor

Urology

University of Texas Southwestern Medical Center

Dallas

TX

Раскрытие информации

RG declares that he has no competing interests.

Выражение благодарностей

Professor Claus Roehrborn and Dr Ramy Goueli would like to gratefully acknowledge Professor Michael T. Flannery and Dr Erika Abel, the previous contributors to this topic. Regretfully, Professor Flannery died in December 2020.

Раскрытие информации

EA declares that she has no competing interests.

Рецензенты

Christopher R. Chapple, BSc, MD, FRCS (Urol), FEBU

Consultant Urological Surgeon

Royal Hallamshire Hospital

Honorary Senior Lecturer of Urology

University of Sheffield

Newcastle University

Visiting Professor of Urology

Sheffield Hallam University

Adjunct Secretary responsible for Education

European Association of Urology

Sheffield

UK

Divulgaciones

CRC is Chairman of NICE Male LUTS Guidelines Development Group.

Robert Pickard, MD, FRCS (Urol)

Professor of Urology

Institute of Cellular Medicine

Newcastle University

Newcastle upon Tyne

UK

Divulgaciones

RP has received funding from the UK NHS (NIHR) to undertake commissioned reviews of treatment for benign prostatic enlargement.

Steven K. Brooks, MD

Chief

Department of Surgery

South Seminole Hospital

Longwood

FL

Divulgaciones

SKB is a member of the National Speakers Bureau for Boehringer Ingelheim, Astellas Pharmaceuticals, and Glaxo Pharmaceuticals and has served as a consultant for these companies.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

Sandhu JS, Bixler BR, Dahm P, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH): AUA guideline amendment 2023. J Urol. 2024 Jan;211(1):11-9.Texto completo  Resumen

European Association of Urology. Management of non-neurogenic male LUTS. 2024 [internet publication].Texto completo

Elterman D, Aubé-Peterkin M, Evans H, et al. Update - Canadian Urological Association guideline: male lower urinary tract symptoms/benign prostatic hyperplasia. Can Urol Assoc J. 2022 Aug;16(8):245-56.Texto completo  Resumen

Expert Panel on Urological Imaging; Alexander LF, Oto A, Allen BC, et al. ACR Appropriateness Criteria® lower urinary tract symptoms - suspicion of benign prostatic hyperplasia. J Am Coll Radiol. 2019 Nov;16(11s):S378-83.Texto completo  Resumen

McConnell JD, Roehrborn CG, Bautista O, et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med. 2003 Dec 18;349(25):2387-98. Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
  • Diferenciales

    • Bexiga hiperativa
    • Prostatite aguda
    • Síndrome da dor prostática primária
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  • Guías de práctica clínica

    • Suspected cancer: recognition and referral
    • Management of non-neurogenic male LUTS
    Más Guías de práctica clínica
  • Folletos para el paciente

    Câncer de próstata

    Cateterização (homens): ter um cateter instalado

    Más Folletos para el paciente
  • Calculadoras

    Escore internacional de sintomas prostáticos (International Prostate Symptom Score - IPSS)

    Más Calculadoras
  • Videos

    Cateterismo uretral masculino - Vídeo de demonstração

    Más vídeos
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