Bhargava Saurabh, Canda A Erdem, Chapple Christopher R
Department of Urology, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.
Curr Opin Urol. 2004 Jan;14(1):1-6. doi: 10.1097/00042307-200401000-00001.
In this article we aim to outline the recent advances in the evaluation of a patient with symptoms suggestive of benign prostatic hyperplasia. We define the role of the clinical evaluation and techniques that are evolving for the appropriate management of a patient with benign prostatic hyperplasia. Both non-invasive and invasive investigation techniques are reviewed.
Initiating early and appropriate treatment is the primary aim of investigation for a patient with lower urinary tract symptoms. Both clinical history and examination and appropriate investigations are vital to establishing a diagnosis. Symptom scores, prostate specific antigen and prostate volume were found to closely relate in predicting the progression of benign prostatic hyperplasia and in recent years increased interest has centred on the progression of this disease principally related to the development of new pharmacotherapy. Despite these positive findings further research is needed to develop reliable tools to predict progression. Newer ultrasound techniques hold promise for the future. Conventional pressure flow studies have a defined role in excluding patients who are less likely to benefit from prostatic surgery by providing information on detrusor function; and non-invasive urodynamic techniques need further evaluation but appear to be promising.
The minimal initial evaluation of a patient with benign prostatic hyperplasia should include a thorough history, digital rectal and neurological examinations, symptom scoring (including quality of life and sexual score) and measurement of serum prostate specific antigen. Other methods should be reserved for more complex situations. Attempts should be made at identifying those patients in whom the disease process is likely to progress.
在本文中，我们旨在概述对有良性前列腺增生疑似症状患者进行评估的最新进展。我们明确临床评估的作用以及为恰当管理良性前列腺增生患者而不断发展的技术。对非侵入性和侵入性检查技术均进行了综述。
对下尿路症状患者进行检查的主要目的是尽早开始并进行恰当治疗。临床病史、体格检查以及恰当的检查对于确诊至关重要。症状评分、前列腺特异性抗原和前列腺体积在预测良性前列腺增生进展方面密切相关，并且近年来人们对该疾病进展的兴趣主要集中在与新药物治疗开发相关的方面。尽管有这些积极发现，但仍需要进一步研究以开发可靠的预测进展的工具。更新的超声技术前景广阔。传统的压力流研究通过提供逼尿肌功能信息，在排除不太可能从前列腺手术中获益的患者方面具有明确作用；非侵入性尿动力学技术需要进一步评估，但似乎很有前景。
对良性前列腺增生患者的最低限度初始评估应包括详尽的病史、直肠指检和神经学检查、症状评分（包括生活质量和性功能评分）以及血清前列腺特异性抗原测定。其他方法应留待更复杂的情况使用。应尝试识别那些疾病进程可能进展的患者。
