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Diagnostik des benignen Prostatasyndroms

Diagnostics of benign prostate syndrome

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Zusammenfassung

Die Diagnostik der LUTS („lower urinary tract symptoms“) wird in den deutschen Leitlinien unterteilt in obligatorische und fakultative diagnostische Parameter. Bei den obligatorischen Parametern sind die Anamnese, die klinische Untersuchung, der „International Prostate Symptom Score“ (IPSS), der PSA-Wert (prostataspezifisches Antigen), die Urinanalyse, die Uroflowmetrie und die Sonographie des oberen und unteren Harntrakts. Bei den fakultativen Untersuchungen sind die Druck-Fluss-Studien, das Miktionsprotokoll und die Detrusordickenmessung zu nennen. Gerade die zuletzt genannte Methode kann mit einer hohen positiven Vorhersage eine Blasenauslassobstruktion nachweisen. Mit der Möglichkeit einer differenzierten und risikoadaptierten Abklärung kann eine stadiengerechte Therapie durchgeführt werden.

Abstract

The diagnostic work-up of lower urinary tract symptoms (LUTS) in the German guidelines consists of obligatory and optional diagnostic parameters. Recommendations for assessing LUTS include patient history, symptom questionnaires (IPSS international prostate symptoms score), physical examination, urine analysis, prostate-specific antigen, uroflowmetry, ultrasound examination of the urinary bladder, including postvoid residual urine and ultrasound examination of the upper urinary tract. Optional tests are voiding diary, pressure-flow studies, ultrasound measurement of detrusor wall thickness, urethrocystography and urethrocystoscopy. Ultrasound measurement of detrusor wall thickness in particular has a 95 % positive predictive value in diagnosing bladder outlet obstruction. With all diagnostic parameters it is possible to treat LUTS in a risk-adapted manner.

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Authors and Affiliations

  1. UroClinic Bogenhausen, Richard-Strauss-Straße 82, 81679, München, Deutschland

    M. Seitz , FEBU, FECSM

  2. Urologische Klinik und Poliklinik, Klinikum der Universität München, Ludwig-Maximilians-Universität München, München, Deutschland

    A. Herlemann, G. Magistro & C.G. Stief

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  1. M. Seitz , FEBU, FECSM
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  2. A. Herlemann
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  3. G. Magistro
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  4. C.G. Stief
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Correspondence to M. Seitz , FEBU, FECSM.

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Seitz, M., Herlemann, A., Magistro, G. et al. Diagnostik des benignen Prostatasyndroms. Urologe 52, 193–196 (2013). https://doi.org/10.1007/s00120-012-3085-1

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  • DOI: https://doi.org/10.1007/s00120-012-3085-1

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