Lower urinary tract symptoms and benign prostatic hyperplasia and their impact on quality of life

Abstract

LUTS is an acronym that refers to symptoms affecting the lower urinary tract, which are very common in elderly subjects (between 60 and 70%), and often associated with, but not always caused by, benign prostatic hypertrophy (BPH). BPH is a chronic condition characterized by an increase in the number of cells, particularly in the transition area of the prostate. BPH involves a compression of the surrounding tissues, consequently obstructing vescical voiding. Nycturia and urgency represent the most prevalent symptoms and those with the greatest impact on quality of life measured as urinary-specific healthrelated quality. The prevalence of BPH is directly proportional to age; therefore, the absolute number of subjects affected is growing throughout the world. BPH is one of the most common medical conditions affecting those over 50. The overall cost for the diagnosis and treatment of BPHrelated LUTS, in the US, has been estimated at approximately 1.1 billion US$/year, compared to total annual expenditure for urological conditions of some 9 billion and this cost continues to increase. The quick prostate test, which was developed by the Italian Urology Society (SIU), is an easy to use instrument that can be utilized in first-level screening for evaluation of the male population with LUTS. This test can be used both in patients not on pharmacological treatment and as a therapy-monitoring instrument. A positive response to one of the questions is sufficient for requesting a more in-depth investigation, which may provide indications on the therapeutic strategy to be taken. Definition of lower urinary tract symptomsLUTS is an acronym that refers to symptoms affecting the lower urinary tract, which are very common in elderly subjects, and often associated with, but not always caused by, benign prostatic hypertrophy (BPH). 1,2Anatomically speaking, the lower urinary tract consists of the bladder, bladder outlet, prostate, distal sphincter mechanism and urethra. BPH is undoubtedly the most common cause of LUTS, but they can also be caused by: i) overactive bladder; ii) prostatitis; iii) nocturnal polyuria; iv) urinary tract infections; v) prostate cancer; vi) other genital/urinary system tumours; vii) significant comorbidities (for example diabetes, congested heart failure, metabolic disease and obesity, medical nephropathy, vascular disease, etc.); viii) concomitant the rapies; ix) bladder stones; x) prior pelvic surgery; xi) trauma; xii) individual or combined central/peripheral nervous system abnormalities. These situations must be kept in careful consideration in differential diagnosis, when choosing a treatment option. 2One approach, that is not however universally accepted, is to divide LUTS into obstructive (or pertaining to the voiding phase) and irritative (or pertaining to the filling phase) ( Table 1).

Validação Do Pictograma Simplificado Anuf Para Avaliação De Sintomas Do Trato Urinário Inferior

“…Sintomas do trato Urinário inferior, do inglês, "lower urinary tract symptoms" (LUTS) afetam entre 60 e 70% da população masculina e feminina em todo o mundo, contudo são mais comuns em idosos principalmente do sexo masculino (CARBONE et al, 2015).…”

“…A hiperplasia benigna da próstata (HBP) é a principal causa de LUTS na população masculina. (CARBONE et al, 2015). É uma doença crônica caracterizada por alterações na próstata, resultando em LUTS.…”

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Sintomas do trato urinário inferior; questionários; urodinâmica.

INTRODUÇÃOSintomas do trato Urinário inferior, do inglês, "lower urinary tract symptoms" (LUTS) afetam entre 60 e 70% da população masculina e feminina em todo o mundo, contudo são mais comuns em idosos principalmente do sexo masculino (CARBONE et al, 2015).Os LUTS são divididos em sintomas de armazenamento (frequência, urgência, incontinência), sintomas miccionais (dificuldade de urinar, hesitação), sintomas pósmiccionais (esvaziamento incompleto da bexiga) e outros (dor na bexiga, síndromes). Em homens, os sintomas mais comuns são noctúria, frequência diurna, dificuldade de esvaziamento, sensação de esvaziamento incompleto e urgência.

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“…Dentre essas, noctúria é o sintoma com maior impacto negativo e que mais prejudica a qualidade de vida (HOMMA et al, 2017).A hiperplasia benigna da próstata (HBP) é a principal causa de LUTS na população masculina. (CARBONE et al, 2015). É uma doença crônica caracterizada por alterações na próstata, resultando em LUTS.…”

Validação De Um Questionário Simplificado (Qpt) Para Avaliação De Sintomas Do Trato Urinário Inferior

“…Em homens, os mais comuns são polaciúria, dificuldade de esvaziamento, urgência e noctúria. A causa mais comum de LUTS no homem é a hiperplasia prostática benigna (CARBONE et al, 2015;HOMMA et al, 2017).…”