Diagnosis of disorders of urination in men with benign prostatic hyperplasia

Relevance. Benign prostatic hyperplasia is a widespread disease among men of middle, elderly and senile age. The main clinical manifestations of prostatic hyperplasia are urination disorders, the so-called lower urinary tract symptoms (LUTS). The main goals of treating patients with prostatic hyperplasia are to improve the quality of life by eliminating the symptoms of urinary disorders, preventing the occurrence of complications [14]. Despite the developed absolute and relative indications for the surgical treatment of prostatic hyperplasia, the results of this type of treatment do not always suit the surgeon and satisfy the patient. The "golden standard” of surgical treatment of prostate adenoma is transurethral resection of the prostate (TURP). According to different authors, 20% to 50% of patients have the same symptoms of urination disorder as before the operation. [6,8,9]. In this connection, the purpose of our work was to establish the diagnosis and rationale for the surgical treatment of prostatic hyperplasia, to study the nature and severity of urinary disorders prior to surgery. Materials and methods. The study was conducted on the basis of urological department № 3 of the Regional Clinical Hospital "Regional Clinical Hospital No. 3" in the city of Chelyabinsk. 120 patients were observed with BPH diagnosis from 1 year to 15 years. The age of patients varies from 52 to 83 years. All patients entered the urological department to perform surgical intervention-a transurethral resection of the prostate. All patients before the operative treatment and after twice performed an FMS, an invasive UDI and a pressure-flow study. Results. On the basis of our preoperative survey, we established that all patients had moderate and severe LUTS. Complex urodynamic examination with LUTS, namely pressure-flow allows objectively to identify infravesical obstruction, which is characterized by an increase in detrusor pressure and a decrease in the flow rate of urine. Symptoms of the lower middle and severe urinary tract and infravesical obstruction caused by BPH, the absence of the effect of conservative therapy allowed to substantiate the surgical treatment of TURP to all patients, which led to the conclusion that timely detection of infravesical obstruction and detrusor hyperactivity in men with prostatic hyperplasia gland is of great practical importance. Taking these factors into account allows us to reasonably suggest surgical intervention and eliminate infravesical obstruction, correcting the symptoms of bladder filling with medication. The absence of infravesical obstruction in the presence of neurogenic dysfunction of the bladder allows in some cases to refrain from an unjustified operation.

Доброкачественная гиперплазия предстательной железы, симптомы нижних мочевых путей, инфравезикальная обструкция, уродинамическое исследование, Benign prostatic hyperplasia, lower urinary tract symptoms, infravesical obstruction, urodynamic examination

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