男性下尿路良性前列腺增生在2019冠状病毒病期间和之后的处理

D. Elterman, J. Baard, M. Averbeck, M. Hassouna, S. Takahashi, I. Chibuzo, A. Sebastianelli, M. Gacci
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引用次数: 0

摘要

下尿路(LUT),特别是前列腺,理论上被认为是SARS-CoV-2的目标。此外,BPE/LUTS和COVID-19的共同病理生理机制已被描述,包括RAS失调、雄激素受体和met相关因素。这些因素引起了人们对COVID-19患者BPE/LUTS进展可能导致泌尿系统预后恶化的担忧。现有结果表明,SARS-CoV-2感染、LUTS加重或新发与精液损伤之间存在相关性。BPE患者的护理和管理受到新冠肺炎疫情的深刻影响。在大流行期间,主要的泌尿学指南建议推迟与bph相关的可延期医疗检查和手术。因此,远程医疗获得了关注和兴趣。生活质量受损或并发症的临床证据加快了手术干预。必须在手术72小时内提供涵盖COVID-19风险的知情同意和阴性分子PCR。建议在全身麻醉下减少手术。大流行期间,全球范围内出现了长时间的等待名单,导致对BPE等待名单和患者临床状况进行定期审查,鼓励了微创办公室手术的增加,即使在covid -19后时代也是如此,并改善了远程医疗。仍需要前瞻性研究来评估COVID-19后LUTS/BPE患者的病程。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Management of Men With Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia During and After COVID-19
The lower urinary tract (LUT), in particular the prostate, has been theoretically recognized as a target for SARS-CoV-2. Moreover, common pathophysiological mechanisms have been described for BPE/LUTS and COVID-19, including RAS dysregulation, androgen receptors, and MetS-related factors. These factors raise concerns about the possibility of worse urological outcomes due to BPE/LUTS progression in COVID-19 patients. The available results suggest a correlation between SARS-CoV-2 infection, exacerbation or new onset of LUTS, and semen impairment. BPE patients’ care and management have been deeply affected by COVID-19. In the midst of the pandemic, the main urological guidelines suggested postponement of BPH-related deferrable medical examinations and surgery. Telemedicine, therefore, gained attention and interest. Clinical evidence of impaired QoL or complications expedited surgical intervention. An informed consent covering the risk of COVID-19 and a negative molecular PCR within 72 hours of surgery were mandatory. A reduction in procedures under general anaesthesia was recommended. Long waiting lists accrued worldwide during the pandemic, leading to regular review of the BPE waiting lists and patients’ clinical status, encouraging the increase of minimally invasive office-based procedures, even in the post-COVID-19 era, and the improvement of telemedicine. Prospective studies are still needed to assess the course of LUTS/BPE patients after COVID-19.
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