Managing lower urinary tract symptoms in men.

Practitioner Pub Date : 2016-04-01
Kenneth R MacKenzie, Jonathan J Aning
{"title":"Managing lower urinary tract symptoms in men.","authors":"Kenneth R MacKenzie,&nbsp;Jonathan J Aning","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>Male lower urinary tract symptoms (LUTS) are common and increase in prevalence with age. Up to 90% of men aged 50 to 80 may suffer from troublesome LUTS. Men may attend expressing direct concern about micturition, describing one or more LUTS and the related impact on their quality of life. Frequently men may present for other medical or urological reasons such as concern regarding their risk of having prostate cancer or erectile dysfunction but on taking a history bothersome LUTS are identified. Men may present late in the community with urinary retention: the inability to pass urine. A thorough urological history is essential to inform management. It is important to determine whether men have storage or voiding LUTS or both. All patients must have a systematic comprehensive examination including genitalia and a digital rectal examination. Investigations performed in primary care should be guided by the history and examination findings, taking into account the impact of the LUTS on the individual's quality of life. Current NICE guidelines recommend the following to be performed at initial assessment: frequency volume chart (FVC); urine dipstick to detect blood, glucose, protein, leucocytes and nitrites; and prostate specific antigen. Men should be referred for urological review if they have: bothersome LUTS which have not responded to conservative management or medical therapy; LUTS in association with recurrent or persistent UTIs; urinary retention; renal impairment suspected to be secondary to lower urinary tract dysfunction; or suspected urological malignancy. All patients not meeting criteria for immediate referral to urology can be managed initially in primary care. Based on history, examination and investigation findings an individualised management plan should be formulated. Basic lifestyle advice should be given regarding reduction or avoidance of caffeinated products and alcohol. The FVC should guide advice regarding fluid intake management and all medications should be reviewed.</p>","PeriodicalId":39516,"journal":{"name":"Practitioner","volume":"260 1792","pages":"11-6, 2"},"PeriodicalIF":0.0000,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Practitioner","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Male lower urinary tract symptoms (LUTS) are common and increase in prevalence with age. Up to 90% of men aged 50 to 80 may suffer from troublesome LUTS. Men may attend expressing direct concern about micturition, describing one or more LUTS and the related impact on their quality of life. Frequently men may present for other medical or urological reasons such as concern regarding their risk of having prostate cancer or erectile dysfunction but on taking a history bothersome LUTS are identified. Men may present late in the community with urinary retention: the inability to pass urine. A thorough urological history is essential to inform management. It is important to determine whether men have storage or voiding LUTS or both. All patients must have a systematic comprehensive examination including genitalia and a digital rectal examination. Investigations performed in primary care should be guided by the history and examination findings, taking into account the impact of the LUTS on the individual's quality of life. Current NICE guidelines recommend the following to be performed at initial assessment: frequency volume chart (FVC); urine dipstick to detect blood, glucose, protein, leucocytes and nitrites; and prostate specific antigen. Men should be referred for urological review if they have: bothersome LUTS which have not responded to conservative management or medical therapy; LUTS in association with recurrent or persistent UTIs; urinary retention; renal impairment suspected to be secondary to lower urinary tract dysfunction; or suspected urological malignancy. All patients not meeting criteria for immediate referral to urology can be managed initially in primary care. Based on history, examination and investigation findings an individualised management plan should be formulated. Basic lifestyle advice should be given regarding reduction or avoidance of caffeinated products and alcohol. The FVC should guide advice regarding fluid intake management and all medications should be reviewed.

管理男性下尿路症状。
男性下尿路症状(LUTS)是常见的,患病率随着年龄的增长而增加。高达90%的50至80岁的男性可能患有麻烦的LUTS。男性可能会直接表达对排尿的担忧,描述一种或多种LUTS及其对生活质量的相关影响。通常情况下,男性可能会因为其他医学或泌尿系统的原因而出现,比如担心他们患前列腺癌或勃起功能障碍的风险,但在记录了令人烦恼的LUTS病史后,他们就被确定了。男性可能在社区晚期出现尿潴留:无法排尿。全面的泌尿病史对治疗至关重要。重要的是要确定男性是否有储存或排尿LUTS或两者兼而有之。所有患者必须进行系统的全面检查,包括生殖器和直肠指检。在初级保健中进行的调查应以病史和检查结果为指导,同时考虑到LUTS对个人生活质量的影响。目前的NICE指南建议在初始评估时执行以下操作:频率容积图(FVC);尿试纸用于检测血液、葡萄糖、蛋白质、白细胞和亚硝酸盐;前列腺特异性抗原。如果男性有以下情况,应转介泌尿科复查:顽固性尿路综合征,保守治疗或药物治疗无效;与复发性或持续性uti相关的LUTS;尿潴留;怀疑继发于下尿路功能障碍的肾脏损害;或怀疑泌尿系统恶性肿瘤。所有不符合立即转诊泌尿外科标准的患者可在初级保健中进行初步管理。应根据病史、检查和调查结果制定个性化的管理方案。应该提供基本的生活方式建议,减少或避免摄入含咖啡因的产品和酒精。FVC应指导有关液体摄入管理的建议,并应审查所有药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Practitioner
Practitioner Medicine-Family Practice
自引率
0.00%
发文量
1
期刊介绍: The term "practitioner" of course has general application. It is used in a wide variety of professional contexts and industry and service sectors. The Practioner.Com portal is intended to support professionals in a growing number of these. Across a range of sub-sites, we offer a raft of useful information and data on the core topic(s) covered. These range from Legal Practioner (legal profession) through ITIL Practitioner (IT Infrastructure Library), Information Security Practitioner, Insolvency Practitioner (IP), General Practitioner and beyond.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信