Vasanwala Farhad Fakhrudin, Wong Michael Yuet Chen, Ho Henry Sun Sien, Foo Keong Tatt
Department of Family Medicine, Sengkang Hospital at Alexandra Hospital, SingHealth, Singapore.
International Urology, Fertility and Gynaecology Centre, Mount Elizabeth Medical Centre, Singapore.
Asian J Urol. 2017 Jul;4(3):181-184. doi: 10.1016/j.ajur.2017.05.003. Epub 2017 Jun 14.
Male patients with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) are increasingly seen by family physicians worldwide due to ageing demographics. A systematic way to stratify patients who can be managed in the community and those who need to be referred to the urologist is thus very useful. Good history taking, physical examination, targeted blood or urine tests, and knowing the red flags for referral are the mainstay of stratifying these patients. Case selection is always key in clinical practice and in the setting of the family physician. The best patient to manage is one above 40 years of age, symptomatic with nocturia, slower stream and sensation of incomplete voiding, has a normal prostate-specific antigen level, no palpable bladder, and no haematuria or pyuria on the labstix. The roles of α blockers, 5-α reductase inhibitors, and antibiotics in a primary care setting to manage this condition are also discussed.
由于人口老龄化，全球家庭医生接诊患有下尿路症状（LUTS）和良性前列腺增生（BPH）的男性患者越来越多。因此，采用一种系统的方法对可在社区管理的患者和需要转诊给泌尿科医生的患者进行分层非常有用。详细的病史采集、体格检查、针对性的血液或尿液检查以及了解转诊的警示信号是对这些患者进行分层的主要方法。病例选择在临床实践以及家庭医生的工作环境中始终是关键。最适合管理的患者是年龄在40岁以上，有夜尿、尿流缓慢和排尿不尽感等症状，前列腺特异性抗原水平正常，膀胱不可触及，并且尿试纸检查无血尿或脓尿的患者。本文还讨论了α受体阻滞剂、5-α还原酶抑制剂和抗生素在基层医疗环境中对这种疾病的管理作用。
