Role of Bladder Functional Testing Prior to Surgeries for Benign Prostatic Obstruction.

IF 2.5 2区 医学 Q2 UROLOGY & NEPHROLOGY
Charles Mazeaud, Natalia Hernandez, Ricardo R Gonzalez
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引用次数: 0

Abstract

Purpose of review: There is no consensus on preoperative functional testing prior to surgeries for benign prostatic obstruction causing lower urinary tract symptoms (LUTS).

Recent findings: Surgical management offers definite benefits, but the results are not always satisfactory. The urodynamic study (UDS) is the gold standard for assessing bladder outlet obstruction (BOO) which is the best predictor of surgical success. Yet, it is not recommended by our urologic societies as standard testing prior to surgery. In this narrative review of the literature, we report recent findings and controversies regarding the benefits and downside of UDS, and the use of other less-invasive approaches to achieve this goal. The lack of strong evidence for or against performing UDS was surprising. Prospective UDS data may not predict surgical outcomes if there is no consensus on criteria that directs surgical intervention. However, confirming the presence of BOO and characterizing the bladder function to identify detrusor over- and underactivity may help counselling and setting patient's post-operative expectations. Urocuff, a non-invasive testing offers promising results to address this problem with a less-invasive assessment of BOO. We emphasize better pre-operative characterization of patients to confirm BOO and better define subgroups to improve surgical decision-making.

Abstract Image

良性前列腺梗阻手术前膀胱功能检查的作用。
综述的目的:对于引起下尿路症状(LUTS)的良性前列腺阻塞手术前的术前功能检查尚无共识。最近的发现:手术治疗提供了明确的好处,但结果并不总是令人满意。尿动力学研究(UDS)是评估膀胱出口梗阻(BOO)的金标准,是手术成功的最佳预测指标。然而,泌尿外科协会不建议将其作为手术前的标准检查。在这篇文献综述中,我们报告了关于UDS的利弊的最新发现和争议,以及使用其他侵入性较小的方法来实现这一目标。支持或反对使用UDS的有力证据的缺乏令人惊讶。如果在指导手术干预的标准上没有共识,前瞻性UDS数据可能无法预测手术结果。然而,确认BOO的存在和描述膀胱功能以识别逼尿肌过度和活动不足可能有助于咨询和设定患者的术后期望。Urocuff是一种非侵入性测试,通过对BOO的低侵入性评估,提供了有希望的结果来解决这个问题。我们强调更好的术前特征,以确认BOO和更好地定义亚组,以改善手术决策。
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来源期刊
Current Urology Reports
Current Urology Reports UROLOGY & NEPHROLOGY-
CiteScore
4.60
自引率
3.80%
发文量
39
期刊介绍: This journal intends to review the most important, recently published findings in the field of urology. By providing clear, insightful, balanced contributions by international experts, the journal elucidates current and emerging approaches to the care and prevention of urologic diseases and conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as benign prostatic hyperplasia, erectile dysfunction, female urology, and kidney disease. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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