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- Title
Diagnostik des benignen Prostatasyndroms: Die deutsche S2e-Leitlinie 2023 Teil 1.
- Authors
Oelke, Matthias; Abt, S. Dominik; Becher, Klaus F.; Dreikorn, Kurt; Madersbacher, Stephan; Magistro, Giuseppe; Michel, Martin C.; Muschter, Rolf; Reich, Oliver; Rieken, Malte; Salem, Johannes; Schönburg, Sandra; Höfner, Klaus; Bschleipfer, Thomas
- Abstract
Background: Lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH; in German guidelines: benign prostatic syndrome [BPS]) is the most frequent urological disease in men and can result in a considerable deterioration of quality-of-life. BPS can be associated with LUTS, benign prostatic enlargement (BPE), and bladder outlet obstruction (BOO) or benign prostatic obstruction (BPO), respectively. The expert group on BPS of the German Society of Urology has re-evaluated the tests for the assessment of BPH and provides evidence-based recommendations. Objectives: Presentation and evidence-based rating of tests for the assessment of patients with BPS. Materials and methods: Summary and overview of chapters 5, 6, and 8 of the latest long version of the German S2e guideline on BPS. Results: The diagnostic work-up should clarify (1) whether the complaints of the patient are caused by BPS, (2) how relevant the complaints are and whether treatment is necessary, (3) whether complications of the lower or upper urinary tract already exist, and (4) which treatment will be most suitable. Baseline assessment should be done in all BPS patients and include history, measurement of LUTS and quality-of-life, urinalysis, serum prostate-specific antigen, post-void residual, ultrasound of the lower urinary tract, including measurements of prostate volume, intravesical prostatic protrusion and detrusor wall thickness, and ultrasound of the upper urinary tract. Additional tests can follow when questions remain unanswered after baseline assessment. These optional tests include bladder diaries, uroflowmetry, serum creatinine, urethrocystoscopy, other noninvasive tests for the determination of BOO/BPO such as penile cuff test, condom catheter method and near-infrared spectroscopy, and other imagining tests such as X‑ray and MRI investigations. Conclusions: The updated German S2e guideline summarizes evidence-based recommendations on the diagnostic work-up, including the assessment of the BPS components BPE, LUTS, and BOO/BPO.
- Subjects
GERMANY; CLINICAL pathology; X-rays; NEAR infrared spectroscopy; CYSTOSCOPY; EVIDENCE-based medicine; MAGNETIC resonance imaging; BENIGN prostatic hyperplasia; MEDICAL protocols; DIAGNOSTIC imaging; URINARY organs; MEDICAL history taking; QUALITY of life; URINARY organ diseases; URINALYSIS; PROSTATE-specific antigen; BLADDER diseases; MEDICAL societies; CREATININE; SYMPTOMS
- Publication
Die Urologie, 2023, Vol 62, Issue 8, p805
- ISSN
2731-7064
- Publication type
Article
- DOI
10.1007/s00120-023-02142-0