Evaluation and management of transient lower urinary tract symptoms (LUTS) after surgery for Benign prostatic obstruction (BPO): a systematic review

IF 6.9 2区医学 Q1 ONCOLOGY

Prostate Cancer and Prostatic Diseases Pub Date : 2026-04-08 DOI:10.1038/s41391-026-01082-y

Giacomo Gallo, Riccardo Lombardo, Antonio Cicione, Jean-Nicolas Cornu, Antonio Franco, Ferdinando Fusco, Sachin Malde, Celeste Manfredi, Christopher Netsch, Malte Rieken, Stavros Gravas, Mauro Gacci, Cosimo De Nunzio

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引用次数: 0

Abstract

The evaluation and management of lower urinary symptoms (LUTS) experienced in the immediate post-operative period after benign prostatic obstruction surgery (BPO), remain unclear. Aim of our study is to systematically report the evidence on management of post-operative transient urinary symptoms after BPO surgery. A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist (PRISMA). PubMed, Embase, Scopus and Cochrane databases were searched up to March 2025. Studies evaluating pharmacotherapy, phytotherapy and/or physical treatment for post-operative transient LUTS in men aged were evaluated. Only randomized clinical trials (RCTs) were included. Overall, nine RCTs were included. Among the surgical techniques investigated, most data were available for transurethral resection of the prostate. The methods used to assess post-operative LUTS, as well as the timing of evaluation, varied considerably across studies. The most commonly submitted questionnaire was the International Prostate Symptom Score, and the most frequently performed diagnostic tool was uroflowmetry. Anticholinergic drugs seems to have the greatest efficacy in improving post-operative LUTS, even if the level of evidence is low. In contrast, alpha-blockers did not appear to offer significant additional benefits in this setting of patients. Phytocomplexes (Graminex G63, Curcumin complexes) were effective in improving patients’ quality of life (QoL) after BPO surgery. Pelvic floor muscle exercises (PFME) also demonstrated a reduction in symptom-related bother. Current strategies for evaluating and managing transient postoperative LUTS are heterogeneous, and available evidence remains limited. Anticholinergic agents and phytotherapeutic compounds are among the most commonly prescribed treatments, though their efficacy is suboptimal. High-quality randomized trials are needed to provide robust clinical recommendations.

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良性前列腺梗阻（BPO）术后一过性下尿路症状（LUTS）的评估和处理：一项系统综述。

背景：良性前列腺梗阻手术（BPO）术后立即出现的下尿症状（LUTS）的评估和处理尚不清楚。我们研究的目的是系统地报告BPO手术后一过性泌尿系统症状的处理证据。方法：根据系统评价和荟萃分析首选报告项目清单（PRISMA）对文献进行系统评价。PubMed, Embase， Scopus和Cochrane数据库被检索到2025年3月。评估老年男性术后短暂性LUTS的药物治疗、植物治疗和/或物理治疗的研究进行了评估。仅纳入随机临床试验（rct）。结果：共纳入9项随机对照试验。在调查的手术技术中，大多数数据是经尿道前列腺切除术。用于评估术后LUTS的方法以及评估的时间在不同的研究中差异很大。最常提交的问卷是国际前列腺症状评分，最常使用的诊断工具是尿流测量。抗胆碱能药物似乎在改善术后LUTS方面最有效，即使证据水平很低。相比之下，在这种情况下，α受体阻滞剂似乎没有提供显著的额外益处。植物复合物（Graminex G63、姜黄素复合物）可有效改善BPO术后患者的生活质量。盆底肌肉锻炼（PFME）也显示减少症状相关的麻烦。结论：目前评估和处理术后短暂性LUTS的策略是不同的，可用的证据仍然有限。抗胆碱能药物和植物治疗化合物是最常用的治疗方法，尽管它们的疗效并不理想。需要高质量的随机试验来提供可靠的临床建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Prostate Cancer and Prostatic Diseases 医学-泌尿学与肾脏学

CiteScore

10.00

自引率

6.20%

发文量

142

审稿时长

6-12 weeks

期刊介绍： Prostate Cancer and Prostatic Diseases covers all aspects of prostatic diseases, in particular prostate cancer, the subject of intensive basic and clinical research world-wide. The journal also reports on exciting new developments being made in diagnosis, surgery, radiotherapy, drug discovery and medical management. Prostate Cancer and Prostatic Diseases is of interest to surgeons, oncologists and clinicians treating patients and to those involved in research into diseases of the prostate. The journal covers the three main areas - prostate cancer, male LUTS and prostatitis. Prostate Cancer and Prostatic Diseases publishes original research articles, reviews, topical comment and critical appraisals of scientific meetings and the latest books. The journal also contains a calendar of forthcoming scientific meetings. The Editors and a distinguished Editorial Board ensure that submitted articles receive fast and efficient attention and are refereed to the highest possible scientific standard. A fast track system is available for topical articles of particular significance.