Abstract | INTRODUCTION: Medical or surgical treatment of lower urinary tract symptoms associated with the bladder obstruction due to BPH must take into account patient's comorbidities and tBPH complication. The objective is to review the different situations in order to optimize the treatment. METHODS: RESULTS: Some co-morbidities and complications may affect surgical outcomes: age is associated with increased anesthetic and surgical risks, diabetes with detrusor hypoactivity or overactivity that will not always be improved by surgery, chronic bladder retention with detrusor underactivity risk and anticoagulants and antiaggregants with an additional bleeding risk. Bladder stone should be treated with, in the majority of cases, BPH surgery. Bladder diverticulum is an indication of BPH surgery but not systematically associated with diverticulectomy. Persistent hematuria despite treatment with 5 alpha reductase inhibitor and repeated urinary tract infection are indications for surgery. CONCLUSION: The presence of co-morbidities or complication related to BPH leads to specifics of care that should not be ignored urologists. LEVEL OF EVIDENCE: 5 consensus d'experts.
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Authors | A Descazeaud, G Robert, A de La Taille |
Journal | Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie
(Prog Urol)
Vol. 28
Issue 15
Pg. 868-874
(Nov 2018)
ISSN: 1166-7087 [Print] France |
Vernacular Title | Prise en charge de l’obstacle sous vésical lié à une HBP chez les patients à terrain particulier et/ou ayant une complication. |
PMID | 30220535
(Publication Type: Journal Article, Review)
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Copyright | Copyright © 2018 Elsevier Masson SAS. All rights reserved. |
Topics |
- Blood Coagulation Disorders
(complications, epidemiology, therapy)
- Catheters, Indwelling
(adverse effects)
- Comorbidity
- Diabetes Complications
(epidemiology, therapy)
- Diverticulum
(complications, epidemiology, therapy)
- Humans
- Lower Urinary Tract Symptoms
(complications, epidemiology, therapy)
- Male
- Prostatic Hyperplasia
(complications, epidemiology, therapy)
- Renal Insufficiency
(complications, epidemiology, therapy)
- Urinary Bladder
(abnormalities)
- Urinary Bladder Neck Obstruction
(epidemiology, etiology, therapy)
- Urinary Retention
(epidemiology, etiology, therapy)
- Urinary Tract Infections
(complications, epidemiology, therapy)
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