Bschleipfer T, Oelke M, Rieken M
Klinik für Urologie, Andrologie und Kinderurologie, Klinikum Weiden/Kliniken Nordoberpfalz AG, Söllnerstr. 16, 92637, Weiden, Deutschland.
Klinik für Urologie, Kinderurologie & Urologische Onkologie, St. Antonius-Hospital, Möllenweg 22, 48599, Gronau, Deutschland.
Urologe A. 2019 Mar;58(3):238-247. doi: 10.1007/s00120-019-0870-0.
Lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH) is the most common condition affecting the lower urinary tract of men. Evidence-based assessment is the basis for an ideal treatment approach.
To provide an overview of the current status of diagnostic measures for LUTS/BPH.
Descriptive review of the literature on the diagnosis of LUTS/BPH.
A medical history inquiring about LUTS/BPH symptoms and burden as well as a standardized and validated symptom questionnaire such as the International Prostate Symptom Score (IPSS) are the basis of the assessment. A physical examination including a rectal exam and the ultrasonography of the lower and upper urinary tract are also part of the basic diagnostic workup. Prostate size is ideally measured by transrectal ultrasound. Serum prostate-specific antigen measurement may help to estimate the prostate size and the risk fo progression. It can also be helpful in the detection of prostate cancer. Urine dipstick or sediment is used to exclude urinary tract infection, hematuria, or glucosuria. Voiding dysfunction can be detected by uroflowmetry. In addition to the aforementioned examinations, further tests such as frequency-voiding charts, multichannel urodynamic evaluation, measurement of detrusor wall thickness and X‑ray imaging of the upper urinary tract as well as a cystoscopy may be offered if needed.
Diagnostics of LUTS/BPH consist of basic exams as well as optional exams and can be used to assess the progression risk, to identify complications and to offer the ideal treatment.
良性前列腺增生所致下尿路症状（LUTS/BPH）是影响男性下尿路的最常见病症。循证评估是理想治疗方法的基础。
概述LUTS/BPH诊断措施的现状。
对LUTS/BPH诊断相关文献进行描述性综述。
询问LUTS/BPH症状及负担的病史以及标准化且经过验证的症状问卷，如国际前列腺症状评分（IPSS），是评估的基础。包括直肠指检以及下尿路和上尿路超声检查在内的体格检查也是基本诊断检查的一部分。理想情况下，通过经直肠超声测量前列腺大小。血清前列腺特异性抗原检测有助于估计前列腺大小及疾病进展风险，也有助于前列腺癌的检测。尿试纸条或尿沉渣检查用于排除尿路感染、血尿或糖尿。通过尿流率测定可检测排尿功能障碍。除上述检查外，如有需要，还可进行进一步检查，如排尿频率图表、多通道尿动力学评估、逼尿肌壁厚度测量、上尿路X线成像以及膀胱镜检查。
LUTS/BPH的诊断包括基本检查和可选检查，可用于评估疾病进展风险、识别并发症并提供理想的治疗方案。
