Vasdev Nikhil, Kumar Ashish, Veeratterapillay Rajan, Thorpe Andrew C
Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK.
Curr Urol. 2013 Jan;6(3):146-9. doi: 10.1159/000343529. Epub 2012 Dec 21.
Hematuria secondary to benign prostatic hyperplasia (BPH) can occur due to a vascular primary gland itself or due to the vascular re-growth of the prostate following a transurethral resection of the prostate (TURP). We aim to evaluate the clinical presentation and management in patients within both these groups.
We retrospectively archived the data of 166 men diagnosed with hematuria secondary to BPH from our hematuria clinic database from March 2003 and March 2006. The 166 patients were divided into 2 groups: Group I (n = 94) hematuria with no previous TURP; Group II (n = 72) hematuria with previous TURP. The clinical management in both groups included reassurance, commencement of a 5-alpha reductase inhibitor (finasteride) or a primary TURP in Group I or re-do TURP in Group II.
The median age was 73 years (range 45-94 years) for both groups. Outcomes combined for both groups included: reassurance alone in 26% (n = 43), finasteride in 51% (n = 84) and TURP in 12% (n = 19). Patients managed with reassurance alone or TURP had no further episodes of hematuria. At a mean follow-up was 18 months (range 7-22 months), 2 patients treated with finasteride re-bled but did require further intervention. A further 2 men elected to stop finasteride due to erectile dysfunction and gynecomastia respectively.
BPH can present with hematuria. Following re-evaluation in a hematuria clinic, the lack of any subsequent cancer diagnosis in these patients suggests that repeat hematuria investigations should be carefully re-considered.
良性前列腺增生（BPH）继发的血尿可能源于前列腺本身的血管问题，也可能是经尿道前列腺电切术（TURP）后前列腺血管再生所致。我们旨在评估这两组患者的临床表现及治疗方法。
我们回顾性分析了2003年3月至2006年3月期间从血尿门诊数据库中确诊为BPH继发血尿的166名男性患者的数据。这166名患者分为两组：第一组（n = 94）为既往未行TURP的血尿患者；第二组（n = 72）为既往行TURP的血尿患者。两组的临床治疗方法包括安慰患者、开始使用5α还原酶抑制剂（非那雄胺），第一组为初次TURP，第二组为再次TURP。
两组患者的中位年龄均为73岁（范围45 - 94岁）。两组综合治疗结果包括：单纯安慰治疗的患者占26%（n = 43），使用非那雄胺治疗的患者占51%（n = 84），接受TURP治疗的患者占12%（n = 19）。单纯接受安慰治疗或TURP治疗的患者未再出现血尿。平均随访18个月（范围7 - 22个月），2名接受非那雄胺治疗的患者再次出血，但无需进一步干预。另有2名男性患者分别因勃起功能障碍和男性乳房发育而选择停用非那雄胺。
BPH可导致血尿。在血尿门诊进行重新评估后，这些患者未被诊断出后续患有癌症，这表明应仔细重新考虑重复进行血尿检查。
