Резюме
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- presença de fatores de risco
- sintomas de armazenamento
- sintomas de micção
Другие диагностические факторы
- febre com disúria
- retenção urinária
Факторы риска
- idade superior a 50 anos
- história familiar de HPB
- raça não asiática
- tabagismo
- alopécia androgênica
- síndrome metabólica
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
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
Алгоритм лечения
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
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.
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