1
|
Oelke M, Abt SD, Becher KF, Dreikorn K, Madersbacher S, Magistro G, Michel MC, Muschter R, Reich O, Rieken M, Salem J, Schönburg S, Höfner K, Bschleipfer T. [Diagnostic work-up of benign prostatic hyperplasia : The German S2e-guideline 2023 part 1]. UROLOGIE (HEIDELBERG, GERMANY) 2023:10.1007/s00120-023-02142-0. [PMID: 37401972 DOI: 10.1007/s00120-023-02142-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 07/05/2023]
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.
Collapse
Affiliation(s)
- Matthias Oelke
- Klinik für Urologie, Urologische Onkologie und Roboter-assistierte Chirurgie, St. Antonius-Hospital GmbH, Möllenweg 22, 48599, Gronau, Deutschland.
| | - S Dominik Abt
- Klinik für Urologie, Spitalzentrum Biel, Biel, Schweiz
| | - Klaus F Becher
- Klinik für Rehabilitation, Klinik Wartenberg Professor Dr. Selmair GmbH & Co. KG, Wartenberg, Deutschland
| | | | | | - Giuseppe Magistro
- Klinik für Urologie, Asklepios Westklinikum GmbH, Hamburg, Deutschland
| | - Martin C Michel
- Abteilung Pharmakologie, Johannes Gutenberg Universität, Mainz, Deutschland
| | - Rolf Muschter
- Urologische Abteilung, ALTA Klinik, Bielefeld, Deutschland
| | - Oliver Reich
- Urologische Privatpraxis Prof. Dr. Oliver Reich, München, Deutschland
| | | | - Johannes Salem
- CUROS urologisches Zentrum, Klinik LINKS VOM RHEIN, Köln, Deutschland
- Klinik für Urologie und Kinderurologie, Universitätsklinikum, Medizinische Hochschule Brandenburg Theodor Fontane, Brandenburg a.d. Havel, Deutschland
| | - Sandra Schönburg
- Universitätsklinik und Poliklinik für Urologie, Martin-Luther Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Klaus Höfner
- Klinik für Urologie, Evangelisches Krankenhaus, Oberhausen, Deutschland
| | - Thomas Bschleipfer
- Klinik für Urologie und Kinderurologie, Regiomed Klinikum, Coburg, Deutschland
| |
Collapse
|
2
|
Janjua TK, Yousuf MA, Iqbal MT, Memon SM, Abdullah A, Faridi N, Irfan M. Incidental finding of prostate cancer in Transurethral Resection of Prostate (TURP) specimens: a retrospective analysis from a Tertiary Care Hospital in Pakistan. Pan Afr Med J 2021; 39:20. [PMID: 34394811 PMCID: PMC8348362 DOI: 10.11604/pamj.2021.39.20.26931] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 04/29/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction incidental prostate cancer findings reflect the great burden of prostatic cancer across the globe. Our 10 year retrospective analysis aimed to identify the incidence and clinic-pathologic features of prostate cancer incidentally detected in patients undergoing transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH), and to estimate the clinical value of pathologic review of all TURP specimens. Methods after excluding patients with a known diagnosis of prostate cancer prior to TURP a total of 2,386 men (ages 25-98) were identified by pathology (TURP) specimens. Yearly incidences, Gleason score, grade, pathologic stage were recorded for all incidental prostate cancer patients. Results a total of 256 (10.7%) patients were found to have prostate cancer. Mean Age was 68.51±9.22 years. T1a and T1b stage prostatic carcinoma was found in 9.9% and 90.1% of these patients respectively. Forty-nine percent (49%) patients had higher Gleason scores (>7). After subtracting average incidences between 5-year intervals, a statistical rise of almost 4% was found. Conclusion our analysis concludes that a large proportion (10.7%) of patients had incidental prostate cancer and the incidence was increasing in recent years in Pakistan and in comparison, to Asian countries. In Pakistan there is a scarcity of updated national cancer registries. The growing incidence of high Gleason scores requires keen and prompt attention. The diverse ethnic and socioeconomic background of patients propels their propensity towards loss of follow up with already limited tertiary healthcare institutes in Pakistan. This pathologic review of TURP specimens is valuable for Asiatic and non-Asiatic populations.
Collapse
Affiliation(s)
| | | | | | - Shahbaz Mustafa Memon
- Surgery Department, Sherwood Forest Hospitals, NHS Trust, Nottinghamshire, United Kingdom
| | - Aziz Abdullah
- Urology Department, Liaquat National Hospital, Karachi, Pakistan
| | - Naveen Faridi
- Pathology Department, Liaquat National Hospital, Pakistan
| | - Muhammad Irfan
- Biostatistics Department, Liaquat National Hospital, Karachi, Pakistan
| |
Collapse
|
3
|
Güzel Ö, Aslan Y, Balcı M, Tuncel A, Keten T, Erkan A, Atan A. Can Bladder Wall Thickness Measurement Be Used for Detecting Bladder Outlet Obstruction? Urology 2015; 86:439-44. [PMID: 26142716 DOI: 10.1016/j.urology.2015.06.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 05/29/2015] [Accepted: 06/18/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the relationship between bladder wall thickness (BWT) and uroflowmetric parameters and the International Prostate Symptoms Score (IPSS) in patients with lower urinary tract symptoms (LUTS). PATIENTS AND METHODS A total of 236 male patients who had LUTS-related benign prostatic enlargement with serum prostate-specific antigen level ≤4 ng/mL were included in this study. Age and duration of LUTS and IPSS were recorded. BWT was measured using 7.5 mHz suprapubic ultrasonography before uroflowmetry and postvoid residual (PVR) was calculated thereafter. The relationship between BWT and poor indicators for bladder outlet obstruction (BOO) (IPSS >19, Qmax <15 mL/min, PVR >100 cm(3)) was investigated. RESULTS The mean age was 62.5 ± 8.1 (39-77) years and the mean BWT was 3.8 ± 1.5 (1.4-8.7) mm. The mean IPSS, Qmax, PVR, and duration of LUTS were 17.7, 13.7 mL/min, 89.9, and 46.5 months, respectively. A positive correlation was found between BWT and IPSS, PVR and duration of LUTS, whereas a negative correlation was found between BWT and Qmax (P <.001). BWT increased when number of BOO parameters increased. BWT was 2.9 in patients without BOO parameters whereas BWT was 3.5, 4.1, and 4.5 mm in patients with any one, any two, and all parameters of BOO, respectively. CONCLUSION BWT increased when number of BOO parameters increased. We believe that measurement of BWT is an easy, quick, and repeatable test to predict BOO severity.
Collapse
Affiliation(s)
- Özer Güzel
- Department of Urology, Ankara Numune Research and Training Hospital, Ministry of Health, Ankara, Turkey
| | - Yılmaz Aslan
- Department of Urology, Ankara Numune Research and Training Hospital, Ministry of Health, Ankara, Turkey
| | - Melih Balcı
- Department of Urology, Ankara Numune Research and Training Hospital, Ministry of Health, Ankara, Turkey
| | - Altuğ Tuncel
- Department of Urology, Ankara Numune Research and Training Hospital, Ministry of Health, Ankara, Turkey.
| | - Tanju Keten
- Department of Urology, Ankara Numune Research and Training Hospital, Ministry of Health, Ankara, Turkey
| | - Anıl Erkan
- Department of Urology, Ankara Numune Research and Training Hospital, Ministry of Health, Ankara, Turkey
| | - Ali Atan
- Department of Urology, Ankara Numune Research and Training Hospital, Ministry of Health, Ankara, Turkey
| |
Collapse
|