EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic Obstruction

Gratzke, Christian; Bachmann, Alexander; Descazeaud, A.; Drake, Marcus; Madersbacher, Stephan; Mamoulakis, Charalampos; Oelke, Matthias; Tikkinen, Kari A.O.; Gravas, Stavros

doi:10.1016/j.eururo.2014.12.038

Cited by 844 publications

(901 citation statements)

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“…Some authors describes the improvement in erectile function and decreasing complications following transurethral resection of the prostate, especially bleeding [23]. EAU guidelines state that this herbal extracts significantly reduce nocturia in comparison with placebo [17]. On the contrary, some authors described that Serenoa repens extracts have not shown more effectiveness than placebo in the treatment of BPH [24][25][26].…”

Section: Discussionmentioning

confidence: 99%

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Effects of Serenoa repens Alcohol Extract on Benign Prostate Hyperplasia

Saidi

Stavridis

Stankov

et al. 2017

Prilozi

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An increasing tendency has recently emerged for the use of phytotherapeutic agents as alternative to commercial pharmacological agents for the treatment of benign prostate hyperplasia (BPH). The purpose of this study is to evaluate the effects of Serenoa repens alcohol extract treatment on BPH patients' symptoms and major parameters during one-year follow-up. The study was performed on 70 men aged 40 -79 years (mean 60.58) with symptomatic BPH that were divided into a group of 40 patients treated with Serenoa repens extract (SRT) and a control group of 30 patients that received no treatment and were observed only. The following parameters were determined at the time of diagnosis (baseline), and after 6 and 12 months: prostate size, serum prostate-specific antigen (PSA) and uroflowmetry parameters including maximum flow rate (MFR), average flow rate (AFR) and post-voiding residual volume (PVRV). In addition, the relevant patient symptoms were evaluated using the International Prostate Symptom Score (IPSS) system. The patients in the SRT group showed a statistically significant increment of the average MFR and AFR values and reduction of PV relative to the control group (p<0.05). The significant differences between the proportion of patients with prostate volume >40 ml in the SRE treated group vs. control group was observed (p<0.05). The mean IPSS score was highly significantly reduced in the SRT group (p<0.01). The mild improvements of the urine flow, prostate size and IPSS score during 12 months treatment with the Serenoa repens extract indicate possible efficiency of this phytotherapeutic agent in patients with BPH.

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Section: Discussionmentioning

confidence: 99%

“…The relevant patient symptoms were evaluated using the International Prostate Symptom Score (IPSS) system. All diagnostic and patient evaluation procedures were performed following the established clinical practice at the Urology Clinic and according to the European Association of Urology (EAU) Guidelines [17].…”

Section: Methodsmentioning

confidence: 99%

Effects of Serenoa repens Alcohol Extract on Benign Prostate Hyperplasia

Saidi

Stavridis

Stankov

et al. 2017

Prilozi

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“…In urology guidelines, especially in cases with small-sized prostates (<30 cm 3 ), and in patients where the risk of postoperative retrograde ejaculation should be taken into consideration, TUIP is recommended. [14,15] Abd-El Kader et al [16] prospectively compared recently performed cases who had undergone TUIP, and TURP, and found similarly effective outcomes for both methods carried out for prostates weighing ≤30 gr.…”

Section: Discussionmentioning

confidence: 99%

The outcomes of transurethral incision/resection of the prostate (TUIP/TURP) performed early after renal transplantation

Sarıer

Duman

Demir

et al. 2018

Turkish Journal of Urology

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Objective: In the early period after renal transplantation, urinary retention stemming from bladder outlet obstruction (BOO) may directly affect graft success. The aim of this study was to evaluate the early and long-term outcomes of transurethral resection of the prostate (TURP) and transurethral incision of prostate (TUIP) procedures performed in the first month following RT due to BOO. Material and methods:Between February 2009 and March 2016, 38 male patients underwent TURP/ TUIP due to BOO within the first 30 days of renal transplantation. The urodynamic and renal function assessment results of all patients were collected during the pre-and postoperative periods. All patients were followed up for a minimum of 12 months for short and long-term complications. The results were evaluated retrospectively. Results:The mean age of the patients who underwent operations was 59.2±12 years. The median duration of dialysis was 41 months (range 0-180). Before the operation the mean serum creatinine (sCr) level was 1.8±0.7 mg/dL, the mean total PSA level was 1.6±1.1 ng/mL. Of the voiding parameters, the mean Qmax and Qave were measured as 8.2±4.5 mL/sec and 4.6±2.5 mL/sec, respectively. The median post-micturition residual urine (PMR) was 105 mL (range 10-400). TURP/TUIP operations were performed at a median of 19 days (range 8-30) after renal transplantations. None of the patients experienced major complications. In the early postoperative period, 5 patients (13.1%) developed urinary tract infection. The mean decrease in sCr in the first month following TURP/TUIP was 1.4±0.4 mg/dL (p<0.001). The mean Qmax (22.4±11.1 mL/sec), and Qave (11.7±5.4 mL/sec) increased significantly (p<0.001), while the median PMR (15 mL, range 0-205) decreased significantly (p<0.001). The mean follow-up period after the procedure was 46.8±23.3 months. During the follow-up period, 3 (7.8%) patients suffered from urethral stricture and 2 (5.2%) patients from bladder neck obstruction. Conclusion:In the surgical treatment of urinary retention arising from BOO in the first month following renal transplantation, TURP/TUIP yield safe and successful results. In addition, regarding the short and long term outcomes, these procedures may be safely performed with low morbidity.

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“…Where such evidence is lacking, other factors come into play, such as opinion, service delivery, cost and convenience. In the European Association of Urology Guidelines on Nonneurogenic Male lower urinary tract symptoms (LUTS) [2], the research evaluated in urodynamics was only rated as Level of Evidence C. Consequently, the Delphi process was used to derive consensus based on expert opinion. Only partial agreement was gained and there was even discrepancy between age groups (that pressure flow studies "may" be performed in men aged over 80 years, and "should" be if aged under 50 years).…”

mentioning

confidence: 99%

“…Routinely, all men with persisting bothersome voiding LUTS are expected to undergo history and examination, with symptom scores, urinalysis, flow rate testing and post void residual measurement [2].…”

mentioning

confidence: 99%