| 词条 | Lower urinary tract symptoms |
| 释义 |
| name = Lower urinary tract symptoms | synonym = LUTS, prostatism | image = | image_size = | alt = | caption = | pronounce = | specialty = Urology | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} Lower urinary tract symptoms (LUTS) refer to a group of clinical symptoms involving the bladder, urinary sphincter, urethra, and, in men, the prostate. Although LUTS is a preferred term for prostatism,[1] and it is more common for the term to be applied to men;[2] lower urinary tract symptoms also affect women.[3] A patient can suffer from one or more lower urinary tract symptom at a time, and recurrence is not uncommon.{{medical citation needed|date=September 2017}} LUTS affect approximately 40% of older men.[4] Symptoms and signsSymptoms can be categorised into: Filling (storage) or irritative symptoms
Voiding or obstructive symptoms
As the symptoms are common and non-specific, LUTS is not necessarily a reason to suspect prostate cancer.[1] Large studies of patients have also failed to show any correlation between lower urinary tract symptoms and a specific diagnosis.[6]{{nonspecific|date=September 2017}} Causes{{^|To avoid gender bias; this list has been alphabetised. An alternative NPOV ordering system would be disease incidence; but would need data.}}
DiagnosisThe International Prostate Symptom Score (IPSS) can be used to gauge the symptoms, along with physician examination. Other primary and secondary tests are often carried out, such as a PSA (Prostate-specific antigen) test,[11] urinalysis, ultrasound, urinary flow studies, imaging, temporary prostatic stent placement, prostate biopsy and/or cystoscopy. Placement of a temporary prostatic stent as a differential diagnosis test can help identify whether LUTS symptoms are directly related to obstruction of the prostate or to other factors worth investigation. TreatmentTreatment will depend on the cause, if one is found. For example; with a UTI, a course of antibiotics would be given.{{medical citation needed|date=September 2017}} With prostatic causes of LUTS; the first line of treatment is medical, which includes alpha-1 blockade and antiandrogens.{{medical citation needed|date=September 2017}} If medical treatment fails, or is not an option; a number of surgical techniques to destroy part or all of the prostate have been developed. Surgical treatmentSurgical treatment of LUTS can include: {{^|To avoid gender bias; this list has been alphabetised.)}}
Lifestyle changesOther treatments include lifestyle advice; for example, avoiding dehydration in recurrent cystitis. Men with prostatic hypertrophy are advised to sit down whilst urinating.[15] A 2014 meta-analysis found that, for elderly males with LUTS, sitting to urinate meant there was a decrease in post-void residual volume (PVR, ml), increased maximum urinary flow (Qmax, ml/s), which is comparable with pharmacological intervention, and decreased the voiding time (VT, s).[16] The improved urodynamic profile is related to a lower risk of urologic complications, such as cystitis and bladder stones.[16] Epidemiology
References{{refbegin}}
1. ^1 {{cite journal |author=Abrams P |title=New words for old: lower urinary tract symptoms for "prostatism" |journal=BMJ |volume=308 |issue=6934 |pages=929–30 |date=April 1994 |pmid=8173393 |pmc=2539789 |url=http://www.bmj.com/cgi/content/full/308/6934/929 |doi=10.1136/bmj.308.6934.929}} 2. ^{{cite web|title=Lower Urinary Tract Symptoms in Women {{!}} Doctor|url=https://patient.info/doctor/lower-urinary-tract-symptoms-in-women-pro|website=patient.info|accessdate=7 September 2017}} 3. ^{{cite journal|last1=Takahashi|first1=Satoru|last2=Takei|first2=Mineo|last3=Nishizawa|first3=Osamu|last4=Yamaguchi|first4=Osamu|last5=Kato|first5=Kumiko|last6=Gotoh|first6=Momokazu|last7=Yoshimura|first7=Yasukuni|last8=Takeyama|first8=Masami|last9=Ozawa|first9=Hideo|last10=Shimada|first10=Makoto|last11=Yamanishi|first11=Tomonori|last12=Yoshida|first12=Masaki|last13=Tomoe|first13=Hikaru|last14=Yokoyama|first14=Osamu|last15=Koyama|first15=Masayasu|title=Clinical Guideline for Female Lower Urinary Tract Symptoms|journal=LUTS: Lower Urinary Tract Symptoms|date=1 January 2016|volume=8|issue=1|pages=5–29|doi=10.1111/luts.12111|pmid=26789539|language=en|issn=1757-5672}} 4. ^RoehrbornCG and McConnell JD: Etiology, pathophusiology, epidemiology, and natural history of benign prostatic hyperplasia. Campell's Urology. WB Saunders Co 2002; chapt 38, p1309. 5. ^1 2 3 {{cite journal |author=Masu S |title=A Prevalence Study of Lower Urinary Tract Symptoms (LUTS) in Males |journal=International Journal of Medical Science and Public Health |volume=3 |issue=8 |pages=927–30 |date=May 2014 |url=http://www.ejmanager.com/mnstemps/67/67-1397632612.pdf?t=1441521003 |doi=10.5455/ijmsph.2014.020520142}} 6. ^Clinical Knowledge Summary; Urological cancer — suspected 7. ^{{Cite journal | doi=10.1111/j.1464-410X.2012.11028.x| pmid=22416998|title = The prevalence and natural history of urinary symptoms among recreational ketamine users| journal=BJU International| volume=110| issue=11| pages=1762–1766|year = 2012|last1 = Winstock|first1 = Adam R.| last2=Mitcheson| first2=Luke| last3=Gillatt| first3=David A.| last4=Cottrell| first4=Angela M.}} 8. ^{{cite journal |author1=Rodolfo Montironi |author2=Marina Scarpelli |author3=Liang Cheng |author4=Antonio Lopez-Beltran |author5=Maurizio Burattini |author6=Ziya Kirkali |author7=Francesco Montorsi |date=December 2013 |title=Immunoglobulin G4-related disease in genitourinary organs: an emerging fibroinflammatory entity often misdiagnosed preoperatively as cancer |url=http://www.europeanurology.com/article/S0302-2838%2812%2901462-5/fulltext/immunoglobulin-g4-related-disease-in-genitourinary-organs-an-emerging-fibroinflammatory-entity-often-misdiagnosed-preoperatively-as-cancer |journal=European Urology |volume=64 |issue=1 |pages=865–872 |doi=10.1016/j.eururo.2012.11.056 |pmid=23266239}} 9. ^{{cite journal |vauthors=Yoshimura Y, Takeda S, Ieki Y, Takazakura E, Koizumi H, Takagawa K |date=1 Sep 2006 |title=IgG4-associated prostatitis complicating autoimmune pancreatitis |url=https://www.jstage.jst.go.jp/article/internalmedicine/45/15/45_15_897/_article |journal=Internal Medicine |volume=45 |issue=15 |pages=897–901 |doi=10.2169/internalmedicine.45.17522 |pmid=16946571|doi-broken-date=2019-03-20 }} 10. ^{{cite journal |vauthors=Nishimori I, Kohsaki T, Onishi S, Shuin T, Kohsaki S, Ogawa Y, Matsumoto M, Hiroi M, Hamano H, Kawa S |date=17 Dec 2007 |title=IgG4-related autoimmune prostatitis: two cases with or without autoimmune pancreatitis |journal=Internal Medicine |volume=46 |issue=24 |pages=1983–1989 |doi=10.2169/internalmedicine.46.0452 |pmid=18084121}} 11. ^The Prostate-Specific Antigen (PSA) Test: Q & A — National Cancer Institute 12. ^{{cite journal|last1=Kramer|first1=MW|last2=Wolters|first2=M|last3=Cash|first3=H|last4=Jutzi|first4=S|last5=Imkamp|first5=F|last6=Kuczyk|first6=MA|last7=Merseburger|first7=AS|last8=Herrmann|first8=TR|title=Current evidence of transurethral Ho:YAG and Tm:YAG treatment of bladder cancer: update 2014.|journal=World Journal of Urology|date=April 2015|volume=33|issue=4|pages=571–9|doi=10.1007/s00345-014-1337-y|pmid=24935098}} 13. ^{{cite journal|last1=Elshal|first1=AM|last2=Elmansy|first2=HM|last3=Elhilali|first3=MM|title=Transurethral laser surgery for benign prostate hyperplasia in octogenarians: safety and outcomes.|journal=Urology|date=March 2013|volume=81|issue=3|pages=634–9|doi=10.1016/j.urology.2012.11.042|pmid=23332997}} 14. ^Fitzpatrick JM. Non-surgical treatment of BPH. Edinburgh: Churchill Livingstone, 1992. 15. ^{{cite web|url=http://www.mednet.nl/wosmedia/1718/mictiehouding_tvu.pdf|title=Influence of voiding posture on urodynamic parameters in men: a literature review|author1=Y. de Jong |author2=R.M. ten Brinck |author3=J.H.F.M. Pinckaers |author4=A.A.B. Lycklama à Nijeholt |publisher=Nederlands Tijdschrift voor urologie|accessdate=2014-07-02}} 16. ^1 {{cite journal|last1=de Jong|first1=Y|last2=Pinckaers|first2=JH|last3=Ten Brinck|first3=RM|last4=Lycklama À Nijeholt|first4=AA|last5=Dekkers|first5=OM|title=Urinating Standing versus Sitting: Position Is of Influence in Men with Prostate Enlargement. A Systematic Review and Meta-Analysis.|journal=PLOS ONE|date=2014|volume=9|issue=7|pages=e101320|doi=10.1371/journal.pone.0101320|pmid=25051345|pmc=4106761}} 17. ^{{cite journal |vauthors=Boyle P, Robertson C, Mazzetta C, etal |title=The prevalence of lower urinary tract symptoms in men and women in four centres. The UrEpik study |journal=BJU Int. |volume=92|issue=4 |pages=409–14 |date=September 2003 |pmid=12930430 |doi=10.1046/j.1464-410x.2003.04369.x}} 18. ^Enlarged prostate gland —treatment, symptoms and cause External links{{Medical resources| ICD10 = {{ICD10|R30}}, {{ICD10|R33}}, {{ICD10|R35}}, {{ICD10|R39}} | ICD9 = {{ICD9|600.00}} {{ICD9|600.01}}, {{ICD9|600.20}}, {{ICD9|600.21}}, {{ICD9|600.90}}, {{ICD9|600.91}} | ICDO = | OMIM = | DiseasesDB = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = | GeneReviewsNBK = | GeneReviewsName = | NORD = | GARDNum = | GARDName = | Orphanet = | AO = | RP = | WO = }}
1 : Urological conditions |
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