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Erschienen in: Der Urologe 3/2019

21.02.2019 | Benigne Prostatahyperplasie | Leitthema

Hartnäckige Mythen zum Thema BPS – und was davon wirklich stimmt!

verfasst von: Prof. Dr. med. Dr. phil. M. Oelke, T. Bschleipfer, K. Höfner

Erschienen in: Die Urologie | Ausgabe 3/2019

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Zusammenfassung

Hintergrund

Das benigne Prostatasyndrom (BPS) ist die vierthäufigste und fünfteuerste Erkrankung von Männern ≥50 Jahre. Obwohl die meisten Urologen zahlreiche Patienten mit BPS behandeln und evidenzbasierte Leitlinien zur Diagnostik und Therapie des BPS vorliegen, halten sich noch zahlreiche Mythen hartnäckig in der Urologie, insbesondere zur Pathophysiologie.

Ziel der Arbeit

Nennung gängiger BPS-Mythen und Darstellung der korrekten Terminologie sowie evidenzbasierten Pathophysiologie.

Material und Methoden

Kritische Betrachtung von 12 ausgewählten BPS-Mythen und Darstellung der korrekten Terminologie sowie Pathophysiologie anhand einer Literaturrecherche (PubMed).

Ergebnisse

Das durchschnittliche Prostatagewicht eines jungen, gesunden, erwachsenen Mannes beträgt zwar 20 g, variiert aber zwischen 8 und 40 g. Das BPS verläuft nicht in Stadien, weshalb die Stadieneinteilungen nach Alken oder Vahlensieck nicht mehr verwendet werden sollten. Es besteht keine feste Beziehung zwischen Blasenauslassobstruktion (BOO) und Prostatagröße, Divertikel/Pseudodivertikel, Restharn, Harnwegsinfektionen, Harnverhalt oder Nierenfunktionsstörung. Die Urethro-Zystoskopie eignet sich nicht zur BOO-Diagnostik. Kein BPS-Medikament kann die BOO relevant reduzieren. Es bestehen keine stichhaltigen Beweise, dass die Prostataresektion vollständig bis zur chirurgischen Kapsel erfolgen muss.

Diskussion

Die Ursachen für die hartnäckige Verwendung überholter Begriffe, alter oder falscher Terminologie sowie falscher pathophysiologischer Zusammenhänge beim BPS sind vielfältig. Ein Grund ist die mangelnde Umsetzung evidenzbasierter Inhalte von Leitlinien bedingt durch mangelndes Wissen, individuelle Überzeugungen, Kosten, Verfügbarkeit und Erstattungspolitik. Ein weiterer Grund ist die zunehmende Fokussierung der Urologie auf onkologische Themen verbunden mit einer unterrepräsentierten Aus- und Weiterbildung zum Thema BPS.
Literatur
1.
Zurück zum Zitat Aagaard J, Jonler M, Fuglsig S et al (1994) Total transurethral resection versus minimal transurethral resection of the prostate – a 10-year follow-up study of urinary symptoms, uroflowmetry and residual volume. Br J Urol 74:333–336CrossRef Aagaard J, Jonler M, Fuglsig S et al (1994) Total transurethral resection versus minimal transurethral resection of the prostate – a 10-year follow-up study of urinary symptoms, uroflowmetry and residual volume. Br J Urol 74:333–336CrossRef
2.
Zurück zum Zitat Abrams PH, Griffiths DJ (1979) The assessment of prostatic obstruction from urodynamic measurements and from residual urine. Br J Urol 51:129–134CrossRef Abrams PH, Griffiths DJ (1979) The assessment of prostatic obstruction from urodynamic measurements and from residual urine. Br J Urol 51:129–134CrossRef
3.
Zurück zum Zitat Abrams PH, Roylance J, Feneley RC (1976) Excretion urography in the investigation of prostatism. Br J Urol 48:681–684CrossRef Abrams PH, Roylance J, Feneley RC (1976) Excretion urography in the investigation of prostatism. Br J Urol 48:681–684CrossRef
4.
Zurück zum Zitat Adot Zurbano JM, Salinas Casado J, Dambros M et al (2005) Urodynamics of the bladder diverticulum in the adult male. Arch Esp Urol 58:641–649PubMed Adot Zurbano JM, Salinas Casado J, Dambros M et al (2005) Urodynamics of the bladder diverticulum in the adult male. Arch Esp Urol 58:641–649PubMed
5.
Zurück zum Zitat Agrawal MS, Aron M, Goel R (2005) Hemiresection of the prostate: short-term randomized comparison with standard transurethral resection. J Endourol 19:868–872CrossRef Agrawal MS, Aron M, Goel R (2005) Hemiresection of the prostate: short-term randomized comparison with standard transurethral resection. J Endourol 19:868–872CrossRef
6.
Zurück zum Zitat Alken CE (1955) Leitfaden der Urologie. Taschenbuch für Studium und Praxis. Thieme, Stuttgart Alken CE (1955) Leitfaden der Urologie. Taschenbuch für Studium und Praxis. Thieme, Stuttgart
7.
Zurück zum Zitat Altwein J, Aumüller G, Berges R et al (1999) Leitlinie der Deutschen Urologen zur Therapie des BPH-Syndroms. Urologe A 38:529–536CrossRef Altwein J, Aumüller G, Berges R et al (1999) Leitlinie der Deutschen Urologen zur Therapie des BPH-Syndroms. Urologe A 38:529–536CrossRef
8.
Zurück zum Zitat Altwein J, Aumüller G, Berges R et al (1999) Leitlinien der Deutschen Urologen zur Diagnostik des BPH-Syndroms. Urologe A 38:297–303CrossRef Altwein J, Aumüller G, Berges R et al (1999) Leitlinien der Deutschen Urologen zur Diagnostik des BPH-Syndroms. Urologe A 38:297–303CrossRef
9.
Zurück zum Zitat Anderson JB, Grant JB (1991) Postoperative retention of urine: a prospective urodynamic study. BMJ 302:894–896CrossRef Anderson JB, Grant JB (1991) Postoperative retention of urine: a prospective urodynamic study. BMJ 302:894–896CrossRef
10.
Zurück zum Zitat Anonymous (1980) Third report on the standardisation of terminology of lower urinary tract function. Procedures related to the evaluation of micturition, pressure-flow relationships, residual urine. Produced by the International Continence Society Committee on Standardisation of Terminology, Nottingham, February 1977. Eur Urol 6:170–171CrossRef Anonymous (1980) Third report on the standardisation of terminology of lower urinary tract function. Procedures related to the evaluation of micturition, pressure-flow relationships, residual urine. Produced by the International Continence Society Committee on Standardisation of Terminology, Nottingham, February 1977. Eur Urol 6:170–171CrossRef
11.
Zurück zum Zitat Antunes AA, Srougi M, Coelho RF et al (2009) Transurethral resection of the prostate for the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia: how much should be resected? Int Braz J Urol 35:683–689 (discussion 689–691)CrossRef Antunes AA, Srougi M, Coelho RF et al (2009) Transurethral resection of the prostate for the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia: how much should be resected? Int Braz J Urol 35:683–689 (discussion 689–691)CrossRef
12.
Zurück zum Zitat Asimakopoulos AD, De Nunzio C, Kocjancic E et al (2016) Measurement of post-void residual urine. Neurourol Urodyn 35:55–57CrossRef Asimakopoulos AD, De Nunzio C, Kocjancic E et al (2016) Measurement of post-void residual urine. Neurourol Urodyn 35:55–57CrossRef
13.
Zurück zum Zitat Bachmann A, Schurch L, Ruszat R et al (2005) Photoselective vaporization (PVP) versus transurethral resection of the prostate (TURP): a prospective bi-centre study of perioperative morbidity and early functional outcome. Eur Urol 48:965–971 (discussion 972)CrossRef Bachmann A, Schurch L, Ruszat R et al (2005) Photoselective vaporization (PVP) versus transurethral resection of the prostate (TURP): a prospective bi-centre study of perioperative morbidity and early functional outcome. Eur Urol 48:965–971 (discussion 972)CrossRef
14.
Zurück zum Zitat Barabas G, Molstad S (2005) No association between elevated post-void residual volume and bacteriuria in residents of nursing homes. Scand J Prim Health Care 23:52–56CrossRef Barabas G, Molstad S (2005) No association between elevated post-void residual volume and bacteriuria in residents of nursing homes. Scand J Prim Health Care 23:52–56CrossRef
15.
Zurück zum Zitat Barnes RW, Bergman RT, Hadley HL (1959) Endoscopy. In: Alken CE, Dix VW, Weyrauch HM, Wildbolz E (eds) Handbuch der Urologie. Springer, Berlin, Göttingen, Heidelberg, pp 210–214 Barnes RW, Bergman RT, Hadley HL (1959) Endoscopy. In: Alken CE, Dix VW, Weyrauch HM, Wildbolz E (eds) Handbuch der Urologie. Springer, Berlin, Göttingen, Heidelberg, pp 210–214
16.
Zurück zum Zitat Barry MJ, Cockett AT, Holtgrewe HL et al (1993) Relationship of symptoms of prostatism to commonly used physiological and anatomical measures of the severity of benign prostatic hyperplasia. J Urol 150:351–358CrossRef Barry MJ, Cockett AT, Holtgrewe HL et al (1993) Relationship of symptoms of prostatism to commonly used physiological and anatomical measures of the severity of benign prostatic hyperplasia. J Urol 150:351–358CrossRef
17.
Zurück zum Zitat Berges R (2008) Epidemiologie des benignen Prostatasyndroms. Assoziierte Risiken und Versorgungsdaten bei deutschen Männern über 50. Urologe A 47:141–148CrossRef Berges R (2008) Epidemiologie des benignen Prostatasyndroms. Assoziierte Risiken und Versorgungsdaten bei deutschen Männern über 50. Urologe A 47:141–148CrossRef
18.
Zurück zum Zitat Berges R, Dreikorn K, Höfner K et al (2003) Leitlinien der Deutschen Urologen zur Diagnostik des benignen Prostatasyndroms (BPS). Urologe A 42:584–590CrossRef Berges R, Dreikorn K, Höfner K et al (2003) Leitlinien der Deutschen Urologen zur Diagnostik des benignen Prostatasyndroms (BPS). Urologe A 42:584–590CrossRef
19.
Zurück zum Zitat Berges R, Dreikorn K, Höfner K et al (2009) Diagnostik und Differenzialdiagnostik des benignen Prostatasyndroms (BPS): Leitlinien der Deutschen Urologen. Urologe A 48:1356–1364CrossRef Berges R, Dreikorn K, Höfner K et al (2009) Diagnostik und Differenzialdiagnostik des benignen Prostatasyndroms (BPS): Leitlinien der Deutschen Urologen. Urologe A 48:1356–1364CrossRef
20.
Zurück zum Zitat Berges R, Oelke M (2011) Age-stratified normal values for prostate volume, PSA, maximum urinary flow rate, IPSS, and other LUTS/BPH indicators in the German male community-dwelling population aged 50 years or older. World J Urol 29:171–178CrossRef Berges R, Oelke M (2011) Age-stratified normal values for prostate volume, PSA, maximum urinary flow rate, IPSS, and other LUTS/BPH indicators in the German male community-dwelling population aged 50 years or older. World J Urol 29:171–178CrossRef
21.
Zurück zum Zitat Berges RR, Pientka L, Höfner K et al (2001) Male lower urinary tract symptoms and related health care seeking in Germany. Eur Urol 39:682–687CrossRef Berges RR, Pientka L, Höfner K et al (2001) Male lower urinary tract symptoms and related health care seeking in Germany. Eur Urol 39:682–687CrossRef
22.
Zurück zum Zitat Berry SJ, Coffey DS, Walsh PC et al (1984) The development of human benign prostatic hyperplasia with age. J Urol 132:474–479CrossRef Berry SJ, Coffey DS, Walsh PC et al (1984) The development of human benign prostatic hyperplasia with age. J Urol 132:474–479CrossRef
23.
Zurück zum Zitat Bosch JL, Hop WC, Kirkels WJ et al (1995) The International Prostate Symptom Score in a community-based sample of men between 55 and 74 years of age: prevalence and correlation of symptoms with age, prostate volume, flow rate and residual urine volume. Br J Urol 75:622–630CrossRef Bosch JL, Hop WC, Kirkels WJ et al (1995) The International Prostate Symptom Score in a community-based sample of men between 55 and 74 years of age: prevalence and correlation of symptoms with age, prostate volume, flow rate and residual urine volume. Br J Urol 75:622–630CrossRef
24.
Zurück zum Zitat Bosch JL, Kranse R, Van Mastrigt R et al (1995) Reasons for the weak correlation between prostate volume and urethral resistance parameters in patients with prostatism. J Urol 153:689–693CrossRef Bosch JL, Kranse R, Van Mastrigt R et al (1995) Reasons for the weak correlation between prostate volume and urethral resistance parameters in patients with prostatism. J Urol 153:689–693CrossRef
25.
Zurück zum Zitat Brookman-May S, Burger M, Hoschke B et al (2010) Association between residual urinary volume and urinary tract infection: prospective trial in 225 male patients. Urologe A 49:1163–1168CrossRef Brookman-May S, Burger M, Hoschke B et al (2010) Association between residual urinary volume and urinary tract infection: prospective trial in 225 male patients. Urologe A 49:1163–1168CrossRef
26.
Zurück zum Zitat Bruskewitz RC, Iversen P, Madsen PO (1982) Value of postvoid residual urine determination in evaluation of prostatism. Urology 20:602–604CrossRef Bruskewitz RC, Iversen P, Madsen PO (1982) Value of postvoid residual urine determination in evaluation of prostatism. Urology 20:602–604CrossRef
27.
Zurück zum Zitat Bschleipfer T, Bach T, Berges R et al (2016) S2e-Leitlinie der Deutschen Urologen : Instrumentelle Therapie des benignen Prostatasyndroms. Urologe A 55:195–207CrossRef Bschleipfer T, Bach T, Berges R et al (2016) S2e-Leitlinie der Deutschen Urologen : Instrumentelle Therapie des benignen Prostatasyndroms. Urologe A 55:195–207CrossRef
28.
Zurück zum Zitat Chen SS, Hong JG, Hsiao YJ et al (2000) The correlation between clinical outcome and residual prostatic weight ratio after transurethral resection of the prostate for benign prostatic hyperplasia. BJU Int 85:79–82CrossRef Chen SS, Hong JG, Hsiao YJ et al (2000) The correlation between clinical outcome and residual prostatic weight ratio after transurethral resection of the prostate for benign prostatic hyperplasia. BJU Int 85:79–82CrossRef
29.
Zurück zum Zitat Crawford ED, Wilson SS, Mcconnell JD et al (2006) Baseline factors as predictors of clinical progression of benign prostatic hyperplasia in men treated with placebo. J Urol 175:1422–1426 (discussion 1426–1427)CrossRef Crawford ED, Wilson SS, Mcconnell JD et al (2006) Baseline factors as predictors of clinical progression of benign prostatic hyperplasia in men treated with placebo. J Urol 175:1422–1426 (discussion 1426–1427)CrossRef
30.
Zurück zum Zitat Donker PJ, Ivanovici F, Noach EL (1972) Analyses of the urethral pressure profile by means of electromyography and the administration of drugs. Br J Urol 44:180–193CrossRef Donker PJ, Ivanovici F, Noach EL (1972) Analyses of the urethral pressure profile by means of electromyography and the administration of drugs. Br J Urol 44:180–193CrossRef
31.
Zurück zum Zitat El Din KE, De Wildt MJ, Rosier PF et al (1996) The correlation between urodynamic and cystoscopic findings in elderly men with voiding complaints. J Urol 155:1018–1022CrossRef El Din KE, De Wildt MJ, Rosier PF et al (1996) The correlation between urodynamic and cystoscopic findings in elderly men with voiding complaints. J Urol 155:1018–1022CrossRef
32.
Zurück zum Zitat El Din KE, Kiemeney LA, De Wildt MJ et al (1996) The correlation between bladder outlet obstruction and lower urinary tract symptoms as measured by the international prostate symptom score. J Urol 156:1020–1025CrossRef El Din KE, Kiemeney LA, De Wildt MJ et al (1996) The correlation between bladder outlet obstruction and lower urinary tract symptoms as measured by the international prostate symptom score. J Urol 156:1020–1025CrossRef
33.
Zurück zum Zitat Elkoushy MA, Elshal AM, Elhilali MM (2015) Holmium laser transurethral incision of the prostate: Can prostate size predict the long-term outcome? Can Urol Assoc J 9:248–254CrossRef Elkoushy MA, Elshal AM, Elhilali MM (2015) Holmium laser transurethral incision of the prostate: Can prostate size predict the long-term outcome? Can Urol Assoc J 9:248–254CrossRef
34.
Zurück zum Zitat Furuya S, Kumamoto Y, Yokoyama E et al (1982) Alpha-adrenergic activity and urethral pressure in prostatic zone in benign prostatic hypertrophy. J Urol 128:836–839CrossRef Furuya S, Kumamoto Y, Yokoyama E et al (1982) Alpha-adrenergic activity and urethral pressure in prostatic zone in benign prostatic hypertrophy. J Urol 128:836–839CrossRef
35.
Zurück zum Zitat Fusco F, Palmieri A, Ficarra V et al (2016) alpha1-blockers improve benign prostatic obstruction in men with lower urinary tract symptoms: a systematic review and meta-analysis of urodynamic studies. Eur Urol 69:1091–1101CrossRef Fusco F, Palmieri A, Ficarra V et al (2016) alpha1-blockers improve benign prostatic obstruction in men with lower urinary tract symptoms: a systematic review and meta-analysis of urodynamic studies. Eur Urol 69:1091–1101CrossRef
36.
Zurück zum Zitat Girman CJ, Jacobsen SJ, Guess HA et al (1995) Natural history of prostatism: relationship among symptoms, prostate volume and peak urinary flow rate. J Urol 153:1510–1515CrossRef Girman CJ, Jacobsen SJ, Guess HA et al (1995) Natural history of prostatism: relationship among symptoms, prostate volume and peak urinary flow rate. J Urol 153:1510–1515CrossRef
37.
Zurück zum Zitat Gosling JA, Dixon JS (1980) Structure of trabeculated detrusor smooth muscle in cases of prostatic hypertrophy. Urol Int 35:351–355CrossRef Gosling JA, Dixon JS (1980) Structure of trabeculated detrusor smooth muscle in cases of prostatic hypertrophy. Urol Int 35:351–355CrossRef
38.
Zurück zum Zitat Gratzke C, Bachmann A, Descazeaud A et al (2015) EAU guidelines on the assessment of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol 67:1099–1109CrossRef Gratzke C, Bachmann A, Descazeaud A et al (2015) EAU guidelines on the assessment of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol 67:1099–1109CrossRef
39.
Zurück zum Zitat Gratzke C, Barber N, Speakman MJ et al (2017) Prostatic urethral lift vs transurethral resection of the prostate: 2‑year results of the BPH6 prospective, multicentre, randomized study. BJU Int 119:767–775CrossRef Gratzke C, Barber N, Speakman MJ et al (2017) Prostatic urethral lift vs transurethral resection of the prostate: 2‑year results of the BPH6 prospective, multicentre, randomized study. BJU Int 119:767–775CrossRef
40.
Zurück zum Zitat Gravas S, Tzortzis V, Melekos MD (2008) Translation of benign prostatic hyperplasia guidelines into clinical practice. Curr Opin Urol 18:56–60CrossRef Gravas S, Tzortzis V, Melekos MD (2008) Translation of benign prostatic hyperplasia guidelines into clinical practice. Curr Opin Urol 18:56–60CrossRef
41.
Zurück zum Zitat Hakenberg OW, Helke C, Manseck A et al (2001) Is there a relationship between the amount of tissue removed at transurethral resection of the prostate and clinical improvement in benign prostatic hyperplasia. Eur Urol 39:412–417CrossRef Hakenberg OW, Helke C, Manseck A et al (2001) Is there a relationship between the amount of tissue removed at transurethral resection of the prostate and clinical improvement in benign prostatic hyperplasia. Eur Urol 39:412–417CrossRef
42.
Zurück zum Zitat Hald T (1989) Urodynamics in benign prostatic hyperplasia: a survey. Prostate Suppl 2:69–77CrossRef Hald T (1989) Urodynamics in benign prostatic hyperplasia: a survey. Prostate Suppl 2:69–77CrossRef
43.
Zurück zum Zitat Hampson SJ, Noble JG, Rickards D et al (1992) Does residual urine predispose to urinary tract infection? Br J Urol 70:506–508CrossRef Hampson SJ, Noble JG, Rickards D et al (1992) Does residual urine predispose to urinary tract infection? Br J Urol 70:506–508CrossRef
44.
Zurück zum Zitat Hofmann R (2017) Endoskopische Urologie: Atlas und Lehrbuch. Springer, Berlin, Heidelberg Hofmann R (2017) Endoskopische Urologie: Atlas und Lehrbuch. Springer, Berlin, Heidelberg
45.
Zurück zum Zitat Höfner K (2018) Restharnbildung durch BOO – ein Mythos. UroForum 3:26–29 Höfner K (2018) Restharnbildung durch BOO – ein Mythos. UroForum 3:26–29
46.
Zurück zum Zitat Höfner K (2014) Wirkung verschiedener BPS-Therapien auf die Blasenauslassobstruktion (BOO). In: Höfner K, Bach T, Berges R, Bschleipfer T, Dreikorn K, Gratzke C, Madersbacher S, Michel MS, Muschter R, Oelke M, Reich O, Tschuschke C (eds) S2e Leitlinie Therapie des benignen Prostatasyndroms (BPS). Deutsche Gesellschaft für Urologie, BoD, München, pp 597–650 Höfner K (2014) Wirkung verschiedener BPS-Therapien auf die Blasenauslassobstruktion (BOO). In: Höfner K, Bach T, Berges R, Bschleipfer T, Dreikorn K, Gratzke C, Madersbacher S, Michel MS, Muschter R, Oelke M, Reich O, Tschuschke C (eds) S2e Leitlinie Therapie des benignen Prostatasyndroms (BPS). Deutsche Gesellschaft für Urologie, BoD, München, pp 597–650
47.
Zurück zum Zitat Höfner K, Bach T, Berges R et al (2016) S2e-Leitlinie der Deutschen Urologen : Konservative und medikamentose Therapie des benignen Prostatasyndroms. Urologe A 55:184–194CrossRef Höfner K, Bach T, Berges R et al (2016) S2e-Leitlinie der Deutschen Urologen : Konservative und medikamentose Therapie des benignen Prostatasyndroms. Urologe A 55:184–194CrossRef
48.
Zurück zum Zitat Hong SK, Lee ST, Jeong SJ et al (2010) Chronic kidney disease among men with lower urinary tract symptoms due to benign prostatic hyperplasia. BJU Int 105:1424–1428CrossRef Hong SK, Lee ST, Jeong SJ et al (2010) Chronic kidney disease among men with lower urinary tract symptoms due to benign prostatic hyperplasia. BJU Int 105:1424–1428CrossRef
49.
Zurück zum Zitat Issa MM, Fenter TC, Black L et al (2006) An assessment of the diagnosed prevalence of diseases in men 50 years of age or older. Am J Manag Care 12:S83–S89PubMed Issa MM, Fenter TC, Black L et al (2006) An assessment of the diagnosed prevalence of diseases in men 50 years of age or older. Am J Manag Care 12:S83–S89PubMed
50.
Zurück zum Zitat Jakobsen H, Torp-Pedersen S, Juul N (1988) Ultrasonic evaluation of age-related human prostatic growth and development of benign prostatic hyperplasia. Scand J Urol Nephrol Suppl 107:26–31PubMed Jakobsen H, Torp-Pedersen S, Juul N (1988) Ultrasonic evaluation of age-related human prostatic growth and development of benign prostatic hyperplasia. Scand J Urol Nephrol Suppl 107:26–31PubMed
51.
Zurück zum Zitat Kang M, Kim M, Choo MS et al (2016) Urodynamic features and significant predictors of bladder outlet obstruction in patients with lower urinary tract symptoms/benign prostatic hyperplasia and small prostate volume. Urology 89:96–102CrossRef Kang M, Kim M, Choo MS et al (2016) Urodynamic features and significant predictors of bladder outlet obstruction in patients with lower urinary tract symptoms/benign prostatic hyperplasia and small prostate volume. Urology 89:96–102CrossRef
52.
Zurück zum Zitat Kaplan SA, Wein AJ, Staskin DR et al (2008) Urinary retention and post-void residual urine in men: separating truth from tradition. J Urol 180:47–54CrossRef Kaplan SA, Wein AJ, Staskin DR et al (2008) Urinary retention and post-void residual urine in men: separating truth from tradition. J Urol 180:47–54CrossRef
53.
Zurück zum Zitat Ko DS, Fenster HN, Chambers K et al (1995) The correlation of multichannel urodynamic pressure-flow studies and American Urological Association symptom index in the evaluation of benign prostatic hyperplasia. J Urol 154:396–398CrossRef Ko DS, Fenster HN, Chambers K et al (1995) The correlation of multichannel urodynamic pressure-flow studies and American Urological Association symptom index in the evaluation of benign prostatic hyperplasia. J Urol 154:396–398CrossRef
54.
Zurück zum Zitat Lourenco T, Shaw M, Fraser C et al (2010) The clinical effectiveness of transurethral incision of the prostate: a systematic review of randomised controlled trials. World J Urol 28:23–32CrossRef Lourenco T, Shaw M, Fraser C et al (2010) The clinical effectiveness of transurethral incision of the prostate: a systematic review of randomised controlled trials. World J Urol 28:23–32CrossRef
55.
Zurück zum Zitat Mauermayer W (1981) Transurethrale Operationen. Springer, Berlin, Heidelberg, New YorkCrossRef Mauermayer W (1981) Transurethrale Operationen. Springer, Berlin, Heidelberg, New YorkCrossRef
56.
Zurück zum Zitat Mccarthy J (1932) A technical consideration of endoscopic revision of the obstructing prostate. J Urol 28:519–527CrossRef Mccarthy J (1932) A technical consideration of endoscopic revision of the obstructing prostate. J Urol 28:519–527CrossRef
57.
Zurück zum Zitat Mochtar CA, Kiemeney LA, Van Riemsdijk MM et al (2006) Post-void residual urine volume is not a good predictor of the need for invasive therapy among patients with benign prostatic hyperplasia. J Urol 175:213–216CrossRef Mochtar CA, Kiemeney LA, Van Riemsdijk MM et al (2006) Post-void residual urine volume is not a good predictor of the need for invasive therapy among patients with benign prostatic hyperplasia. J Urol 175:213–216CrossRef
58.
Zurück zum Zitat Nesbit RM (1943) Transurethral prostatectomy. Thomas, Springfield Nesbit RM (1943) Transurethral prostatectomy. Thomas, Springfield
59.
Zurück zum Zitat Oelke M, Baard J, Wijkstra H et al (2008) Age and bladder outlet obstruction are independently associated with detrusor overactivity in patients with benign prostatic hyperplasia. Eur Urol 54:419–426CrossRef Oelke M, Baard J, Wijkstra H et al (2008) Age and bladder outlet obstruction are independently associated with detrusor overactivity in patients with benign prostatic hyperplasia. Eur Urol 54:419–426CrossRef
60.
Zurück zum Zitat Oelke M, Höfner K, Wiese B et al (2002) Increase in detrusor wall thickness indicates bladder outlet obstruction (BOO) in men. World J Urol 19:443–452CrossRef Oelke M, Höfner K, Wiese B et al (2002) Increase in detrusor wall thickness indicates bladder outlet obstruction (BOO) in men. World J Urol 19:443–452CrossRef
61.
Zurück zum Zitat Oelke M, Kirschner-Hermanns R, Thiruchelvam N et al (2012) Can we identify men who will have complications from benign prostatic obstruction (BPO)? ICI-RS 2011. Neurourol Urodyn 31:322–326CrossRef Oelke M, Kirschner-Hermanns R, Thiruchelvam N et al (2012) Can we identify men who will have complications from benign prostatic obstruction (BPO)? ICI-RS 2011. Neurourol Urodyn 31:322–326CrossRef
62.
Zurück zum Zitat Omli R, Skotnes LH, Mykletun A et al (2008) Residual urine as a risk factor for lower urinary tract infection: a 1-year follow-up study in nursing homes. J Am Geriatr Soc 56:871–874CrossRef Omli R, Skotnes LH, Mykletun A et al (2008) Residual urine as a risk factor for lower urinary tract infection: a 1-year follow-up study in nursing homes. J Am Geriatr Soc 56:871–874CrossRef
63.
Zurück zum Zitat Osman NI, Chapple CR, Abrams P et al (2014) Detrusor underactivity and the underactive bladder: a new clinical entity? A review of current terminology, definitions, epidemiology, aetiology, and diagnosis. Eur Urol 65:389–398CrossRef Osman NI, Chapple CR, Abrams P et al (2014) Detrusor underactivity and the underactive bladder: a new clinical entity? A review of current terminology, definitions, epidemiology, aetiology, and diagnosis. Eur Urol 65:389–398CrossRef
64.
Zurück zum Zitat Park HK, Paick SH, Lho YS et al (2012) Effect of the ratio of resected tissue in comparison with the prostate transitional zone volume on voiding function improvement after transurethral resection of prostate. Urology 79:202–206CrossRef Park HK, Paick SH, Lho YS et al (2012) Effect of the ratio of resected tissue in comparison with the prostate transitional zone volume on voiding function improvement after transurethral resection of prostate. Urology 79:202–206CrossRef
65.
Zurück zum Zitat Rom M, Waldert M, Klingler HC et al (2013) Bladder outlet obstruction in men with acute urinary retention: an urodynamic study. World J Urol 31:1045–1050CrossRef Rom M, Waldert M, Klingler HC et al (2013) Bladder outlet obstruction in men with acute urinary retention: an urodynamic study. World J Urol 31:1045–1050CrossRef
66.
Zurück zum Zitat Rosier PF, De La Rosette JJ (1995) Is there a correlation between prostate size and bladder-outlet obstruction? World J Urol 13:9–13CrossRef Rosier PF, De La Rosette JJ (1995) Is there a correlation between prostate size and bladder-outlet obstruction? World J Urol 13:9–13CrossRef
67.
Zurück zum Zitat Rule AD, Lieber MM, Jacobsen SJ (2005) Is benign prostatic hyperplasia a risk factor for chronic renal failure? J Urol 173:691–696CrossRef Rule AD, Lieber MM, Jacobsen SJ (2005) Is benign prostatic hyperplasia a risk factor for chronic renal failure? J Urol 173:691–696CrossRef
68.
Zurück zum Zitat Strope SA (2018) Evidence-based guidelines in lower urinary tract symptoms secondary to benign prostatic hyperplasia and variation in care. Curr Opin Urol 28:262–266PubMed Strope SA (2018) Evidence-based guidelines in lower urinary tract symptoms secondary to benign prostatic hyperplasia and variation in care. Curr Opin Urol 28:262–266PubMed
69.
Zurück zum Zitat Strope SA, Elliott SP, Saigal CS et al (2011) Urologist compliance with AUA best practice guidelines for benign prostatic hyperplasia in medicare population. Urology 78:3–9CrossRef Strope SA, Elliott SP, Saigal CS et al (2011) Urologist compliance with AUA best practice guidelines for benign prostatic hyperplasia in medicare population. Urology 78:3–9CrossRef
71.
Zurück zum Zitat Thomas AW, Cannon A, Bartlett E et al (2005) The natural history of lower urinary tract dysfunction in men: minimum 10-year urodynamic follow-up of untreated detrusor underactivity. BJU Int 96:1295–1300CrossRef Thomas AW, Cannon A, Bartlett E et al (2005) The natural history of lower urinary tract dysfunction in men: minimum 10-year urodynamic follow-up of untreated detrusor underactivity. BJU Int 96:1295–1300CrossRef
72.
Zurück zum Zitat Thomas AW, Cannon A, Bartlett E et al (2004) The natural history of lower urinary tract dysfunction in men: the influence of detrusor underactivity on the outcome after transurethral resection of the prostate with a minimum 10-year urodynamic follow-up. BJU Int 93:745–750CrossRef Thomas AW, Cannon A, Bartlett E et al (2004) The natural history of lower urinary tract dysfunction in men: the influence of detrusor underactivity on the outcome after transurethral resection of the prostate with a minimum 10-year urodynamic follow-up. BJU Int 93:745–750CrossRef
73.
Zurück zum Zitat Vahlensieck W (1996) BPH-Stadieneinteilung. BPH-Konferenz, Guernsey, 19.–22.09.1996 Vahlensieck W (1996) BPH-Stadieneinteilung. BPH-Konferenz, Guernsey, 19.–22.09.1996
74.
Zurück zum Zitat Van De Beek C, Rollema HJ, Van Mastrigt R et al (1992) Objective analysis of infravesical obstruction and detrusor contractility; appraisal of the computer program Dx/CLIM and Schäfer nomogram. Neurourol Urodyn 1:394–395 Van De Beek C, Rollema HJ, Van Mastrigt R et al (1992) Objective analysis of infravesical obstruction and detrusor contractility; appraisal of the computer program Dx/CLIM and Schäfer nomogram. Neurourol Urodyn 1:394–395
75.
Zurück zum Zitat Van Exel NJ, Koopmanschap MA, McDonnell J et al (2006) Medical consumption and costs during a one-year follow-up of patients with LUTS suggestive of BPH in six european countries: report of the TRIUMPH study. Eur Urol 49:92–102CrossRef Van Exel NJ, Koopmanschap MA, McDonnell J et al (2006) Medical consumption and costs during a one-year follow-up of patients with LUTS suggestive of BPH in six european countries: report of the TRIUMPH study. Eur Urol 49:92–102CrossRef
76.
Zurück zum Zitat Wikipedia (2018) Mythos. In: Wikipedia, Die freie Enzyklopädie Wikipedia (2018) Mythos. In: Wikipedia, Die freie Enzyklopädie
77.
Zurück zum Zitat Yalla SV, Sullivan MP, Lecamwasam HS et al (1995) Correlation of American Urological Association symptom index with obstructive and nonobstructive prostatism. J Urol 153:674–679 (discussion 679–680)CrossRef Yalla SV, Sullivan MP, Lecamwasam HS et al (1995) Correlation of American Urological Association symptom index with obstructive and nonobstructive prostatism. J Urol 153:674–679 (discussion 679–680)CrossRef
Metadaten
Titel
Hartnäckige Mythen zum Thema BPS – und was davon wirklich stimmt!
verfasst von
Prof. Dr. med. Dr. phil. M. Oelke
T. Bschleipfer
K. Höfner
Publikationsdatum
21.02.2019
Verlag
Springer Medizin
Erschienen in
Die Urologie / Ausgabe 3/2019
Print ISSN: 2731-7064
Elektronische ISSN: 2731-7072
DOI
https://doi.org/10.1007/s00120-019-0885-6

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