Sydney Urological Associates, Sydney Adventist Hospital, Sydney, NSW.
Med J Aust. 2011 Jul 4;195(1):34-9. doi: 10.5694/j.1326-5377.2011.tb03185.x.
Lower urinary tract symptoms (LUTS) are common among Australian men over the age of 45 years; most men with LUTS will have benign prostatic hyperplasia (BPH), overactive bladder (OAB), or both. The cause of LUTS should be diagnosed by assessing symptom severity and excluding of medical or pharmaceutical causes. All men with LUTS should undergo digital rectal examination; other diagnostic tools include urine and blood testing, voiding charts and imaging. Depending on disease severity, impact on quality of life, patient preference, presence of complications and fitness for surgery, BPH is managed with watchful waiting, pharmacotherapy (α-blockers or 5-α-reductase inhibitors), minimally invasive surgical therapies or surgery. OAB is initially treated with behavioural therapy; if this is ineffective, pharmacotherapy (usually antimuscarinics) can be used. Patients with LUTS with a provisional diagnosis other than BPH or OAB, or with complications or poor response to pharmacotherapy, should be referred to a urologist.
下尿路症状（LUTS）在 45 岁以上的澳大利亚男性中很常见；大多数有 LUTS 的男性将患有良性前列腺增生（BPH）、膀胱过度活动症（OAB）或两者兼有。通过评估症状严重程度和排除医疗或药物原因来诊断 LUTS 的原因。所有有 LUTS 的男性都应进行直肠指检；其他诊断工具包括尿液和血液检查、排尿图表和影像学检查。根据疾病严重程度、对生活质量的影响、患者偏好、并发症的存在以及手术适应性，BPH 通过观察等待、药物治疗（α 受体阻滞剂或 5-α 还原酶抑制剂）、微创外科治疗或手术进行管理。OAB 最初采用行为疗法治疗；如果无效，可以使用药物治疗（通常是抗毒蕈碱药物）。对于暂时诊断为 BPH 或 OAB 以外的 LUTS 患者、或有并发症或药物治疗反应不佳的患者，应转介给泌尿科医生。
