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前立腺肥大症の治療指針

排尿困難を訴える男性例に利用すると便利。
出典
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1: 日本泌尿器科学会:男性下部尿路症状・前立腺肥大症診療ガイドライン.リッチヒルメディカル、2017.P4(一部改変)

国際禁制学会による下部尿路症状の分類

下部尿路症状には、主な症状として、蓄尿症状、排尿症状、排尿後症状以外に、性交に伴う症状、骨盤臓器脱に伴う症状、生殖器痛、下部尿路痛、下部尿路機能障害を示唆する症状・症候群がある。
出典
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1: The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society.
Urology. 2003 Jan;61(1):37-49.

おもらしの種類

出典
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1: 岡山コンチネンス研究会監修:知っておきたいオシッコの話―さわやかライフを目指して―、ファイザー(株)、2008.(改変あり)

各下部尿路症状の男女別有症状率

18歳以上の男女を対象にした疫学調査:蓄尿症は女性に多く、排尿症状は男性に多い。
夜間頻尿:1晩で1回以上、排尿のために起きている
頻尿:日中の排尿回数が多すぎるという自覚がある
出典
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1: Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study.
著者: Debra E Irwin, Ian Milsom, Steinar Hunskaar, Kate Reilly, Zoe Kopp, Sender Herschorn, Karin Coyne, Con Kelleher, Christian Hampel, Walter Artibani, Paul Abrams
雑誌名: Eur Urol. 2006 Dec;50(6):1306-14; discussion 1314-5. doi: 10.1016/j.eururo.2006.09.019. Epub 2006 Oct 2.
Abstract/Text: OBJECTIVE: Estimate the prevalence of urinary incontinence (UI), overactive bladder (OAB), and other lower urinary tract symptoms (LUTS) among men and women in five countries using the 2002 International Continence Society (ICS) definitions.
METHODS: This population-based, cross-sectional survey was conducted between April and December 2005 in Canada, Germany, Italy, Sweden, and the United Kingdom using computer-assisted telephone interviews. A random sample of men and women aged >/= 18 yr residing in the five countries and who were representative of the general populations in these countries was selected. Using 2002 ICS definitions, the prevalence estimates of storage, voiding, and postmicturition LUTS were calculated. Data were stratified by country, age cohort, and gender.
RESULTS: A total of 19,165 individuals agreed to participate; 64.3% reported at least one LUTS. Nocturia was the most prevalent LUTS (men, 48.6%; women, 54.5%). The prevalence of storage LUTS (men, 51.3%; women, 59.2%) was greater than that for voiding (men, 25.7%; women, 19.5%) and postmicturition (men, 16.9%; women, 14.2%) symptoms combined. The overall prevalence of OAB was 11.8%; rates were similar in men and women and increased with age. OAB was more prevalent than all types of UI combined (9.4%).
CONCLUSIONS: The EPIC study is the largest population-based survey to assess prevalence rates of OAB, UI, and other LUTS in five countries. To date, this is the first study to evaluate these symptoms simultaneously using the 2002 ICS definitions. The results indicate that these symptoms are highly prevalent in the countries surveyed.
Eur Urol. 2006 Dec;50(6):1306-14; discussion 1314-5. doi: 10.1016/j.eu...

複合する男性下部尿路症状

18歳以上の男性を対象にした疫学調査:多くの例で複合した下部尿路症状を有する。
出典
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1: Prevalence, severity, and symptom bother of lower urinary tract symptoms among men in the EPIC study: impact of overactive bladder.
著者: Debra E Irwin, Ian Milsom, Zoe Kopp, Paul Abrams, Walter Artibani, Sender Herschorn
雑誌名: Eur Urol. 2009 Jul;56(1):14-20. doi: 10.1016/j.eururo.2009.02.026. Epub 2009 Mar 3.
Abstract/Text: BACKGROUND: Lower urinary tract symptoms (LUTS) are prevalent among men.
OBJECTIVE: To describe the prevalence, severity, and symptom bother of LUTS in all men and men with overactive bladder (OAB) symptoms in the EPIC study.
DESIGN, SETTING, AND PARTICIPANTS: A secondary analysis of data from EPIC, a multinational population-based survey of 19,165 adults, was performed. Current International Continence Society definitions were used for individual LUTS and OAB; OAB cases were defined as men reporting urgency.
MEASUREMENTS: Participants were asked about the presence of individual LUTS and associated symptom bother. LUTS severity was measured using the International Prostate Symptom Score (IPSS).
RESULTS AND LIMITATIONS: There was substantial overlap of storage, voiding, and postmicturition symptoms among all men (n=7210) and in men with OAB symptoms (n=502); men with OAB symptoms were more likely to experience multiple LUTS subtypes. Among both populations, nocturia was the most commonly reported symptom, except for urgency (the hallmark symptom) among men with OAB symptoms; terminal dribble and sensation of incomplete emptying were the most common voiding and postmicturition symptoms. The prevalence of all LUTS increased with age among the general population; only storage LUTS increased with age among men with OAB symptoms. Number of LUTS and mean IPSS increased with age in both populations but were higher among men with OAB symptoms at all ages; the proportion reporting moderate-severe LUTS was higher than the general population (30% vs 6%). The proportion of men with OAB symptoms reporting symptom bother increased with urgency severity and severity and number of LUTS. LUTS severity may have been underestimated by the IPSS, which does not assess incontinence.
CONCLUSIONS: Men with LUTS commonly experience coexisting storage, voiding, and postmicturition symptoms, emphasizing the need for comprehensive urologic assessments. Men with OAB symptoms reported more LUTS and greater severity than the general population. Symptom bother was related to number of LUTS and urgency severity.
Eur Urol. 2009 Jul;56(1):14-20. doi: 10.1016/j.eururo.2009.02.026. Epu...

PDE-5阻害薬の特徴

出典
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1: 中原保裕:処方がわかる医療薬理学2022-2023.学研メディカル秀潤社、2022.p400 表4

国際前立腺症状スコア(I-PSS)

出典
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1: 岡山コンチネンス研究会監修:知っておきたいオシッコの話―さわやかライフを目指して―、ファイザー(株)、2008.(改変あり)

男性下部尿路症状診療のアルゴリズム

ADLが比較的よい男性の下部尿路症状に対する基本方針を示す。
出典
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1: 日本泌尿器科学会:男性下部尿路症状・前立腺肥大症診療ガイドライン.リッチヒルメディカル、2017.p2

過活動膀胱の診療アルゴリズム

過活動膀胱かどうか悩む症例に利用すると便利。
出典
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1: 日本排尿機能学会 過活動膀胱診療ガイドライン作成委員会:過活動膀胱診療ガイドライン[第2版].リッチヒルメディカル、2015.p12

夜間頻尿の診療アルゴリズム

夜間頻尿の対応に困ったときに利用してください。
出典
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1: 日本排尿機能学会/日本泌尿器科学会:夜間頻用診療ガイドライン[第2版].リッチヒルメディカル、2020.p2

前立腺肥大症の治療指針

排尿困難を訴える男性例に利用すると便利。
出典
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1: 日本泌尿器科学会:男性下部尿路症状・前立腺肥大症診療ガイドライン.リッチヒルメディカル、2017.P4(一部改変)

国際禁制学会による下部尿路症状の分類

下部尿路症状には、主な症状として、蓄尿症状、排尿症状、排尿後症状以外に、性交に伴う症状、骨盤臓器脱に伴う症状、生殖器痛、下部尿路痛、下部尿路機能障害を示唆する症状・症候群がある。
出典
imgimg
1: The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society.
Urology. 2003 Jan;61(1):37-49.