lower urinary tract symptoms

下部尿路症状, LUTS

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）』「2014/06/16 10:44:44」(JST)

wiki en

[Wiki en表示]

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 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
• Hesitancy
• Terminal dribbling
• Incomplete voiding
• Overflow incontinence (occurs in chronic 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
• Urinary stone
• Malignancy: prostate or bladder
• Neurological disease, e.g. multiple sclerosis, spinal cord injury, cauda equina syndrome

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:

• The best nowadays is 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.

Other treatments include lifestyle advice. Although surgical treatment is generally reserved for men who have failed or are unable to tolerate drug treatment, or for those who have developed complications

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. 前立腺肥大症の内科的治療 medical treatment of benign prostatic hyperplasia
• 3. 慢性細菌性前立腺炎 chronic bacterial prostatitis
• 4. 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
• 5. 男性の尿失禁 urinary incontinence in men

English Journal

• Bloodless management of benign prostatic hyperplasia: medical and minimally invasive treatment options.

• Liatsikos E, Kyriazis I, Kallidonis P, Stolzenburg JU.SourceDepartment of Urology, University of Patras, Greece.
• The aging male : the official journal of the International Society for the Study of the Aging Male.Aging Male.2011 Sep;14(3):141-9. Epub 2011 Jan 19.
• Benign prostatic hyperplasia (BPH) is a medical condition affecting a wide range of the aging male population resulting in various degrees of lower urinary tract symptoms (LUTS). Today, a variety of medical therapies and minimally invasive BPH treatment modalities are available. Medical therapy incl
• PMID 21247241

• Phosphodiesterase Type 5 Inhibitors in the Management of Non-neurogenic Male Lower Urinary Tract Symptoms: Critical Analysis of Current Evidence.

• Martinez-Salamanca JI, Carballido J, Eardley I, Giuliano F, Gratzke C, Rosen R, Salonia A, Stief C.SourceDepartment of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autonoma de Madrid, Madrid, Spain.
• European urology.Eur Urol.2011 Sep;60(3):527-35. Epub 2011 Jun 12.
• CONTEXT: A large body of epidemiologic data suggests a causal relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). Recently reported studies on phosphodiesterase type 5 inhibitors (PDE5-Is) and LUTS have further contributed to the understanding of mechanisms involv
• PMID 21684677

Japanese Journal

• 前立腺肥大症患者に対するシロドシンの初回至適投与量・投与方法の検討

• 和田 直樹,沼田 篤,山口 聡,小山内 裕昭,森 達也,芳生 旭辰,藤澤 真,金子 茂男,柿崎 秀宏
• 泌尿器科紀要 57(6), 297-302, 2011-06
• … We investigated the optimum initial dose and timing of administration of α1A-adrenoceptor antagonist silodosin for treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH/LUTS). …
• NAID 120003221325

• Androgen replacement therapy contributes to improving lower urinary tract symptoms in patients with hypogonadism and benign prostate hypertrophy: A randomised controlled study

• Shigehara Kazuyoshi,Sasagawa Toshiyuki,Doorbar John,Kawaguchi Shohei,Kobori Yoshitomo,Nakashima Takao,Shimamura Masayoshi,Maeda Yuji,Miyagi Tohru,Kitagawa Yasuhide,Kadono Yoshifumi,Konaka Hiroyuki,Mizokami Atsushi,Koh Eitetsu,Namiki Mikio
• Aging Male 14(1), 53-58, 2011-03
• … We performed a randomised controlled study regarding the effects of androgen replacement therapy (ART) on lower urinary tract symptoms (LUTS) in hypogonadal men with benign prostate hypertrophy (BPH). …
• NAID 120002829324

Related Links

• Lower urinary tract symptoms - Wikipedia, the free encyclopedia

From Wikipedia, the free encyclopedia. Jump to: navigation, search. Lower urinary tract symptoms (LUTS) are a common problem affecting approximately 40% of older men. LUTS is a recent term for what used to be known as prostatism. ...

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★リンクテーブル★

リンク元	「下部尿路症状」「LUTS」
関連記事	「lower」「low」「symptom」「lowering」「urinary」

「下部尿路症状」

　　[★]

英

lower urinary tract symptoms, LUTS

関

下部尿路機能障害 LUTD(蓄尿障害と排尿障害の総称)

• 症候 100105I

概念

• 下部尿路機能障害(LUTD)によって出現する自覚症状の総称

下部尿路症状

SURO.37

• 1. 蓄尿症状

• 頻尿(昼間、夜間頻尿)：排尿が1日8回以上、夜間睡眠中1回以上の場合
• 希尿：
• 尿意切迫：過活動膀胱の症状
• 尿失禁

• 2. 排尿症状

• 尿勢低下：BPHの典型的な症状
• 尿線途絶
• 排尿遷延(遷延性排尿、再延性排尿)
• 腹圧排尿
• 排尿時間の延長：苒延性排尿
• 排尿終末滴下

• 3. 排尿後症状

• 残尿感
• 排尿後尿滴：中高年男性では尿道内残尿で起こり、BPHによく見られる。
• 二段尿：膀胱憩室や膀胱尿管逆流症

参考

• http://www.kenkoigaku.or.jp/html/cnt/cnt001.html
• http://www.med.hirosaki-u.ac.jp/~suga/sgcenter/series2/online2.7.pdf

• まとまっている

• http://www.health.ne.jp/word/d2109.html
• 下部尿路機能障害をきたす主な疾患

http://www.luts.gr.jp/070_system/pdf/dl_first2.pdf

「LUTS」

　　[★] 下部尿路症状、lower urinary tract symptoms

「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