Oelke Matthias, Abt S Dominik, Becher Klaus F, Dreikorn Kurt, Madersbacher Stephan, Magistro Giuseppe, Michel Martin C, Muschter Rolf, Reich Oliver, Rieken Malte, Salem Johannes, Schönburg Sandra, Höfner Klaus, Bschleipfer Thomas
Klinik für Urologie, Urologische Onkologie und Roboter-assistierte Chirurgie, St. Antonius-Hospital GmbH, Möllenweg 22, 48599, Gronau, Deutschland.
Klinik für Urologie, Spitalzentrum Biel, Biel, Schweiz.
Urologie. 2023 Aug;62(8):805-817. doi: 10.1007/s00120-023-02142-0. Epub 2023 Jul 4.
Lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH; in German guidelines: benign prostatic syndrome [BPS]) is the most frequent urological disease in men and can result in a considerable deterioration of quality-of-life. BPS can be associated with LUTS, benign prostatic enlargement (BPE), and bladder outlet obstruction (BOO) or benign prostatic obstruction (BPO), respectively. The expert group on BPS of the German Society of Urology has re-evaluated the tests for the assessment of BPH and provides evidence-based recommendations.
Presentation and evidence-based rating of tests for the assessment of patients with BPS.
Summary and overview of chapters 5, 6, and 8 of the latest long version of the German S2e guideline on BPS.
The diagnostic work-up should clarify (1) whether the complaints of the patient are caused by BPS, (2) how relevant the complaints are and whether treatment is necessary, (3) whether complications of the lower or upper urinary tract already exist, and (4) which treatment will be most suitable. Baseline assessment should be done in all BPS patients and include history, measurement of LUTS and quality-of-life, urinalysis, serum prostate-specific antigen, post-void residual, ultrasound of the lower urinary tract, including measurements of prostate volume, intravesical prostatic protrusion and detrusor wall thickness, and ultrasound of the upper urinary tract. Additional tests can follow when questions remain unanswered after baseline assessment. These optional tests include bladder diaries, uroflowmetry, serum creatinine, urethrocystoscopy, other noninvasive tests for the determination of BOO/BPO such as penile cuff test, condom catheter method and near-infrared spectroscopy, and other imagining tests such as X‑ray and MRI investigations.
The updated German S2e guideline summarizes evidence-based recommendations on the diagnostic work-up, including the assessment of the BPS components BPE, LUTS, and BOO/BPO.
提示良性前列腺增生（BPH；在德国指南中为：良性前列腺综合征[BPS]）的下尿路症状（LUTS）是男性中最常见的泌尿系统疾病，可导致生活质量显著下降。BPS可能分别与LUTS、良性前列腺增生（BPE）以及膀胱出口梗阻（BOO）或良性前列腺梗阻（BPO）相关。德国泌尿外科学会BPS专家组重新评估了用于评估BPH的检查，并提供了循证建议。
介绍用于评估BPS患者的检查并进行循证评级。
总结并概述德国关于BPS的最新S2e指南长版的第5、6和8章。
诊断检查应明确：（1）患者的症状是否由BPS引起；（2）症状的相关性如何以及是否需要治疗；（3）下尿路或上尿路是否已经存在并发症；（4）哪种治疗最为合适。所有BPS患者均应进行基线评估，包括病史、LUTS和生活质量测量、尿液分析、血清前列腺特异性抗原、排尿后残余尿量、下尿路超声检查（包括前列腺体积、膀胱内前列腺突出度和逼尿肌壁厚度测量）以及上尿路超声检查。在基线评估后仍有问题未得到解答时，可进行其他检查。这些可选检查包括膀胱日记、尿流率测定、血清肌酐、尿道膀胱镜检查、用于确定BOO/BPO的其他非侵入性检查（如阴茎袖带试验、避孕套导管法和近红外光谱法）以及其他影像学检查（如X线和MRI检查）。
更新后的德国S2e指南总结了关于诊断检查的循证建议，包括对BPS的组成部分BPE、LUTS和BOO/BPO的评估。
