良性前列腺增生症的介绍课件.ppt

* * * * This slide shows uroflowmetry results from a healthy individual and also from an elderly man with BPH. The left side graph is a uroflow study of a healthy 40-year-old male. Note the bell-shaped curve with a Qmax of 27 mL/sec and the flow time of 23 seconds. The right side graph is of an elderly man with LUTS due to BPE. Note the flattened flow curve, the voided volume (which is almost the same as for the healthy man), the moderately impaired Qmax (12 mL/sec), and the flow time of 51 seconds, which is more than twice the duration compared to the normal individual. * * Post-void residual volume (PVR) is defined as the volume of fluid remaining in the bladder immediately following a complete micturition. In normal men this value is less than 12 mL.1 The reason for increased PVR in men with LUTS is not well understood. Grossly increased PVR is strongly associated with a dilated paralysed bladder, and a decompensated detrusor muscle is thought to be the major aetiologic component of increased PVR in bladder outlet obstruction.1 Reference Jepsen JV, Bruskewitz RC. In: Lepor H (ed). Prostatic Diseases. WB Saunders, 2000: 127–142. * This slide shows the assessment of PVR by transabdominal ultrasonography (3.5 MHz). The PVR is 75 mL. Note the significant middle lobe of approximately 2.0 cm and that the bladder wall is moderately thickened as a sign of bladder outflow obstruction. * Data collected by the TransEuropean Research Into the Use of Management Policies for LUTS suggestive of BPH in Primary Health care (TRIUMPH) project were used to profile 4979 patients from six European countries newly presenting with LUTS/BPH to general practitioners or office-based urologists.1 The majority of patients (77%) sought medical advice because of the bothersomeness of their symptoms.1 Reference 1. Hutchison A et al. Eur Urol 2006;50:555–61. * Evaluation of symptom severity is an important part of the initial assessment and helpful in allocating treatment