lower urinary tract symptom

下部尿路通過障害

WordNet

1. unrefined in character; "low comedy"
2. an air mass of lower pressure; often brings precipitation; "a low moved in over night bringing sleet and snow" (同)depression
3. a low level or position or degree; "the stock market fell to a new low"
4. used of sounds and voices; low in pitch or frequency (同)low-pitched
5. very low in volume; "a low murmur"; "the low-toned murmur of the surf" (同)low-toned
6. in a low position; near the ground; "the branches hung low"
7. less than normal in degree or intensity or amount; "low prices"; "the reservoir is low"
8. literal meanings; being at or having a relatively small elevation or upward extension; "low ceilings"; "low clouds"; "low hills"; "the sun is low"; "low furniture"; "a low bow"
9. move something or somebody to a lower position; "take down the vase from the shelf" (同)take_down, let down, get_down, bring_down
10. cause to drop or sink; "The lack of rain had depressed the water level in the reservoir" (同)depress
11. set lower; "lower a rating"; "lower expectations" (同)lour
12. a brief treatise on a subject of interest; published in the form of a booklet (同)pamphlet
13. an extended area of land (同)piece of land, piece of ground, parcel of land, parcel
14. a system of body parts that together serve some particular purpose
15. a drawing created by superimposing a semitransparent sheet of paper on the original image and copying on it the lines of the original image (同)trace
16. the act of drawing a plan or diagram or outline
17. the discovery and description of the course of development of something; "the tracing of genealogies"
18. (medicine) any sensation or change in bodily function that is experienced by a patient and is associated with a particular disease
19. anything that accompanies X and is regarded as an indication of Xs existence

PrepTutorEJDIC

1. (高さ・位置が)『低い』,低い所にある / (価格・数量・程度などが)『低い』,少ない / (身分・地位などが)『低い』,卑しい / (人格・行為などが)『卑しい』,下劣な,下品な / 《補語にのみ用いて》(体が)『弱った』;元気のない,憂うつな / (供給が)不十分な;(…が)乏しい《+『in』(『on』)+『名』》 / (音・声が)低い,小さい / (生物が)下等な / 『低く』,低い所に / (価格・程度などが)『安く』,低く / 低い声(調子)で;静かに / 最低点,最低水準
2. (牛の)モーという鳴き声 / (牛が)モーと鳴く
3. (lowの比較級)『もっと低い』,(価格が)もっと安い / 《名詞の前にのみ用いて》『下級の』;低い(下の)ほうの / …‘を'『下げる』,降ろす / 〈価格・程度・量・調子など〉‘を'『下げる』,小さくする,低下させる / 〈人〉‘を'品位(品格)を落とす / 低くなる,下がる,滅る
4. (…に向かって)顔をしかめる,まゆをひそめる《+『at(on, upon)』+『名』》 / 〈空模様が〉険悪になる,〈雨などが〉降りそうな / しかめっつら / 険悪な空模様
5. 広大な土地(地域),(土地・海・空などの)広がり《+of+名》 / (器官の)管,(神経の)索
6. (おもに宗教・政治などの宣伝用の)小冊子,パンフレット
7. 跡を追うこと,追跡;透写,複写 / 〈C〉 / 透写(複写)によってできたもの(地図・図案など),透写図
8. (病気の)徴候,症状《+of+名》 / (一般)に(…の)徴候,きざし,印《+of+名》

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/06/05 17:28:33」(JST)

wiki en

[Wiki en表示]

"LUTS" redirects here. For other uses, see Luts.

Lower urinary tract symptoms
Synonyms	LUTS, prostatism
Classification and external resources

Lower urinary tract symptoms (LUTS) refer to a group of medical symptoms, that affect approximately 40% of older men. LUTS is a recent term for what used to be known as prostatism.

Symptoms and signs

Symptoms can be categorised into:

Filling (Storage) or irritative symptoms

• Increased frequency of urination
• Increased urgency of urination
• Painful urination
• Excessive passage of urine at night

Voiding or obstructive symptoms

• Poor stream (unimproved by straining)
• Hesitancy (worsened if bladder is very full)
• Terminal dribbling
• Incomplete voiding
• Urinary retention
• Overflow incontinence (occurs in chronic retention)
• Episodes of near retention

As the symptoms are common and non-specific, LUTS is not necessarily a reason to suspect prostate cancer. Large studies of patients have also failed to show any correlation between lower urinary tract symptoms and a specific diagnosis.

Causes

• Benign prostatic hyperplasia (BPH) with obstruction
• Detrusor muscle weakness and/or instability
• Urinary Tract Infection (UTI)
• Chronic prostatitis
• Urethral stricture
• Urinary stone
• Malignancy: prostate or bladder
• Neurological disease, e.g. multiple sclerosis, spinal cord injury, cauda equina syndrome
• IgG4-related prostatitis

Diagnosis

The International Prostate Symptom Score (IPSS) can be used to gauge the symptoms, along with physician examination. Other primary and secondary tests are often carried out, such as a PSA (Prostate-specific antigen) test, urinalysis, ultrasound, urinary flow studies, imaging, temporary prostatic stent placement, prostate biopsy and/or cystoscopy.

Placement of a temporary prostatic stent as a differential diagnosis test can help identify whether LUTS symptoms are directly related to obstruction of the prostate or to other factors worth investigation.

ICD 9 CM

• 600.00 Hypertrophy (benign) of prostate w/o urinary obstruction and other lower urinary tract symptoms (LUTS)
• 600.01 Hypertrophy (benign) of prostate with urinary obstruction and other LUTS
• 600.20 Benign localized hyperplasia of prostate w/o urinary obstruction and other LUTS
• 600.21 Benign localized hyperplasia of prostate with urinary obstruction and other LUTS
• 600.90 Hyperplasia of prostate, unspecified, w/o urinary obstruction and other LUTS
• 600.91 Hyperplasia of prostate, unspecified, with urinary obstruction and other LUTS

Treatment

A number of techniques to destroy part or all of the prostate have been developed. First line of treatment is medical, which includes alpha-1 blockade and antiandrogens. If the medical treatment fails, surgical techniques are done. Techniques include:

• TURP: trans-urethral removal of the prostate
• Transurethral microwave thermotherapy
• Thermal ablation
• High intensity focused ultrasonography
• Transurethral needle ablation
• Laser prostatectomy.
• Intraurethral prostatic stenting and balloon dilatation of the prostate.

Voiding position

Other treatments include lifestyle advice, for example sitting down while urinating. A meta-analysis found that, for elderly males with LUTS:

• the post void residual volume (PVR, ml) was significantly decreased
• the maximum urinary flow (Qmax, ml/s) was increased, comparable with pharmacological intervention
• the voiding time (VT, s) was decreased

This urodynamic profile is related to a lower risk of urologic complications, such as cystitis and bladder stones.

Epidemiology

• Prevalence increases with age. The prevalence of nocturia in older men is about 78%. Older men have a higher incidence of LUTS than older women.
• Around one third of men will develop urinary tract (outflow) symptoms, of which the principal underlying cause is benign prostatic hyperplasia.
• Once symptoms arise, their progress is variable and unpredictable with about one third of patients improving, one third remaining stable and one third deteriorating.
• It is estimated that the lifetime risk of developing microscopic prostate cancer is about 30%, developing clinical disease 10%, and dying from prostate cancer 3%.

References

• Speakman MJ, Kirby RS, Joyce A, Abrams P, Pocock R (May 2004). "Guideline for the primary care management of male lower urinary tract symptoms". BJU Int. 93 (7): 985–90. doi:10.1111/j.1464-410X.2004.04765.x. PMID 15142148. 
• Juliao AA, Plata M, Kazzazi A, Bostanci Y, Djavan B (January 2012). "American Urological Association and European Association of Urology guidelines in the management of benign prostatic hypertrophy: revisited". Current Opinion in Urology. 22 (1): 34–9. doi:10.1097/MOU.0b013e32834d8e87. PMID 22123290. 
• NHS; Cancer Screening Programmes. Prostate Cancer Risk Management.

UpToDate Contents

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• 1. 男性における下部尿路症状 lower urinary tract symptoms in men
• 2. 前立腺肥大症のの臨床症状および診断的評価 clinical manifestations and diagnostic evaluation of benign prostatic hyperplasia
• 3. 前立腺肥大症の内科的治療 medical treatment of benign prostatic hyperplasia
• 4. 女性における慢性尿閉 chronic urinary retention in women
• 5. 男性の尿失禁 urinary incontinence in men

English Journal

• Eraser laser enucleation of the prostate: technique and results.

• Hruby S, Sieberer M, Schätz T, Jones N, Zimmermann R, Janetschek G, Lusuardi L.SourceDepartment of Urology, Paracelsus Medical University Salzburg, Salzburg, Austria. Electronic address: stephan.hruby@gmx.at.
• European urology.Eur Urol.2013 Feb;63(2):341-6. doi: 10.1016/j.eururo.2012.08.049. Epub 2012 Aug 29.
• BACKGROUND: Eraser, a 1318-nm diode laser, has been used for 15 yr for resection of lung metastases. It was recently introduced in urology for small kidney tumors and for the treatment of benign prostatic obstruction.OBJECTIVE: To demonstrate on video our technique of Eraser laser enucleation of the
• PMID 22959050

• The effect of first dose of tamsulosin on flow rate and its predictive ability on the improvement of LUTS in men with BPH in the mid-term.

• Akin Y, Gulmez H, Ucar M, Yucel S.SourceDepartment of Urology, Erzincan University School of Medicine, 24040, Erzincan, Turkey.
• International urology and nephrology.Int Urol Nephrol.2013 Jan 6. [Epub ahead of print]
• PURPOSE: To investigate if effects of the first single dose of tamsulosin 0.4 mg on uroflowmetry parameters would predict treatment response at the third month.METHODS: Men over 40 years old with complaints of lower urinary tract symptoms associated with benign prostatic hyperplasia were studied w
• PMID 23292598

• Nocturia: current concepts and future perspectives.

• Osman NI, Chapple CR, Wein AJ.SourceDepartment of Urology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK.
• Acta physiologica (Oxford, England).Acta Physiol (Oxf).2013 Jan;207(1):53-65. doi: 10.1111/apha.12013. Epub 2012 Oct 15.
• Nocturia is a prevalent highly bothersome urinary symptom that may significantly detriment the health and well-being of sufferers. It is characterized by waking at night to void, each void preceded and followed by sleep, hence leading to fragmentation of sleep and day-time tiredness. This may result
• PMID 23033860

Japanese Journal

• Comparison of 7 α1-adrenoceptor Antagonists in Patients with Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia:A Short-term Crossover Study

• Araki Tohru,Monden Koichi,Araki Motoo
• Acta Medica Okayama 67(4), 245-251, 2013-08-00
• … A crossover study was conducted to identify the best α1-adrenoceptor (α1AR) antagonist for individual patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). … Efficacy was evaluated with the International Prostate Symptom Score. …
• NAID 120005315586

• 排尿障害を受診動機とする包茎を合併した高齢者乾燥性閉塞性亀頭炎の治療経験

• 根本 勺,石舘 卓三
• 泌尿器科紀要 59(6), 341-346, 2013-06-00
• … Preoperative average international prostate symptom score, average maximum urinary flow rate, and average volume of residual urine were 20.7±6.3 points (n＝8), 5.1±3.6 ml/s (n＝5), and 85.4±77.3 ml (n＝8), respectively. … Some of the patient's complaints, such as severe dribbling of urine, urinary stream division, and ballooning of the foreskin, were not included in the items of the major questionnaire on urination. …
• NAID 120005298151

• 前立腺肥大症に伴う男性下部尿路症状に対するナフトピジルとシロドシンの無作為クロスオーバー試験

• 増田 光伸,神座 慎一郎,増子 洋 [他],朝倉 智行,榛葉 隆文
• 泌尿器科紀要 = Acta urologica Japonica 58(12), 671-678, 2012-12-00
• … We compared the efficacy, safety, and patient preferences for two α1-adrenoceptor (AR) antagonists with different affinity for AR subtypes, naftopidil (Naf) and silodosin (Silo), for the treatment of male lower urinary tract symptoms associated with benign prostatic hyperplasia (male LUTS/BPH). … Naf and Silo improved the total International Prostate Symptom Score (IPSS) compared with baseline. …
• NAID 40019530612

Related Links

• urinary symptomの意味・用例｜英辞郎 on the WEB：アルク

urinary symptom 泌尿器症状 urinary symptom score 排尿症状スコア lower urinary tract symptom 下部尿路症状 【略】LUTS improve urinary symptoms 泌尿器症状を改善する Back pain with urinary symptoms may emanate from the ...

• Core lower urinary tract symptom score (CLSS) for the ...

1. Int J Urol. 2011 Nov;18(11):778-84. doi: 10.1111/j.1442-2042.2011.02848.x. Epub 2011 Sep 23. Core lower urinary tract symptom score (CLSS) for the assessment of female lower urinary tract symptoms: a comparative study. ...

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★リンクテーブル★

リンク元	「下部尿路通過障害」
拡張検索	「lower urinary tract symptoms」
関連記事	「lower」「low」「symptom」「lowering」「urinary」

「下部尿路通過障害」

　　[★]

英

lower urinary tract symptom

関

下部尿路閉塞

「lower urinary tract symptoms」

　　[★] 下部尿路症状, LUTS

「lower」

　　[★]

• adj.

• (low比較級)より低い、下位の、下等な、低次の、低下させる、低減させる

関

decline、decrease、depression、drop、fall、inferio、inferior、inferiorly、low level、lower dimension、lower level、lower order、lowering、reduction

　 　 　 　 　

「low」

　　[★]

• adj.

• (比較級lower-最上級lowest)低い、不十分な

関

deficient、inadequate、insufficiency、insufficient、insufficiently、poorly、scanty

　 　 　 　 　 　 　 　 　 　

「symptom」

　　[★]

• n.

• しるし、現れ、兆し(of)。(医)徴候、症状、症候、病徴

関

indication、manifestation、pathology、presentation、sign、stigma、stigmata、symptomatic

　 　 　

「lowering」

　　[★]

• n.

• 低下、低減

関

decline、decrease、depression、drop、fall、lower、reduction

　 　 　 　

「urinary」

　　[★]

• adj.

• 尿の、尿中の、泌尿器の

関

urinary organ、urinary tract、urine、uro