Li Ruoyu, Zhou Yuancheng, Xiao Xingyuan, Li Bing
Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China.
Institute of Urology, Wuhan University, Wuhan, Hubei 430071, China.
Bladder (San Franc). 2024 Nov 21;11(3):e21200017. doi: 10.14440/bladder.2024.0022. eCollection 2024.
Bladder outlet obstruction (BOO) represents a common cause of lower urinary tract symptoms in men, frequently resulting from benign prostatic hyperplasia. Key symptoms include both obstructive and irritative urinary tract symptoms, such as dysuria, increased frequency and urgency of urination, and recurrent urinary tract infections. BOO can also cause upper urinary tract dilation (hydronephrosis), damage structure, and impair function of the bladder.
Early diagnosis of BOO is essential to the protection of kidney and bladder functions. The gold standard for diagnosing BOO is urodynamic studies (UDS), which measure detrusor pressure and urinary flow. However, UDS is an invasive test and is associated with risks for urinary tract infections, bothersome urinary symptoms, and hematuria. Given the invasiveness and discomfort associated with UDS, non-invasive diagnostic methods have been developed. Nevertheless, the main limitation of these techniques is the variability in threshold values, highlighting the need for further standardization of measurement protocols. This article reviews the current diagnostic approaches for BOO in men and explores their clinical utility.
Various non-invasive diagnostic methods are promising; yet, UDS remains the primary diagnostic approach.
膀胱出口梗阻(BOO)是男性下尿路症状的常见原因,通常由良性前列腺增生引起。主要症状包括梗阻性和刺激性尿路症状,如排尿困难、尿频、尿急增加以及反复尿路感染。BOO还可导致上尿路扩张(肾积水)、损害膀胱结构并损害膀胱功能。
BOO的早期诊断对于保护肾脏和膀胱功能至关重要。诊断BOO的金标准是尿动力学检查(UDS),其可测量逼尿肌压力和尿流。然而,UDS是一种侵入性检查,与尿路感染、令人烦恼的尿路症状和血尿风险相关。鉴于UDS具有侵入性且会带来不适,已开发出非侵入性诊断方法。然而,这些技术的主要局限性在于阈值的变异性,这凸显了进一步规范测量方案的必要性。本文综述了目前男性BOO的诊断方法,并探讨了它们的临床应用价值。
各种非侵入性诊断方法前景广阔;然而,UDS仍然是主要的诊断方法。