4.3.1 Sintesi e raccomandazioni - Biblioteca Medica

Pressure-flow studies should be confined to patients with concomitant
neurological disease and/or in whom high flow rate obstruction is suspected
Pressure-flow studies may be useful in patients in whom detrusor
hypocontractility is suspected
A
B
Endoscopy
III
Prostate volume and cervico-urethral obstruction can be assessed by
investigations that are less invasive and more accurate than urethrocystoscopy
III
The incidence of disease involving the lower urinary tract is too low to justify the
routine use of urethrocystoscopy
Urethrocystoscopy is not appropriate for the routine assessment of patients with
LUTS/IPB
D
Urethrocystoscopy should be performed only in patients with a history of
hematuria or vesical carcinoma and risk factors for urethral disorders
B
Watchful waiting
THERAPY
II
I
A measurable reduction in I-PSS is observed during watchful waiting
Only 10% of patients managed by watchful waiting require different treatment
after one year
Watchful waiting is the first choice for patients presenting with mild LUTS that
do not have an impact on quality of life
Watchful waiting is a therapeutic option for patients presenting with moderate
LUTS that do not have an impact on quality of life
A
B
Medical treatment
α 1
- adrenergic blocker therapy
5-α reductase inhibitors
Other treatments
Combination therapy
46
I
α 1
adrenoreceptor blockers produce a significant improvement in symptoms that
patients usually experience as moderate improvement