EAU Guidelines on Neurogenic Lower Urinary Tract Dysfunction
EAU Guidelines on Neurogenic Lower Urinary Tract Dysfunction
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DOI：
10.1016/j.eururo.2009.04.028
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发表时间：
2009-07-01
期刊：
影响因子：
23.4
通讯作者：
Wyndaele, Jean-Jacques
中科院分区：
文献类型：
--
作者：
Stoehrer, Manfred;Blok, Bertil;Wyndaele, Jean-Jacques
背景：大多数神经源性下尿路功能障碍(NLUTD)患者需要终生护理，以维持他们的生活质量(QOL)并最大限度地延长预期寿命。目的：总结2008年版欧洲泌尿学协会(EAU)关于NLUTD的指南，并评估现有诊断工具的有效性，特别是超声成像和尿动力学。证据获取：2008年EAU指南中提供的关于NLUTD的建议基于文献回顾，使用2004年至2007年出版的Medline和其他来源文件。在可能的情况下，已为指南分配了一定程度的证据和/或推荐等级。证据综合：NLUTD涵盖了广泛的病理学，患者通常需要终身、重症医疗护理，以最大限度地延长他们的预期寿命并维持他们的生活质量。治疗必须根据个别患者的需要量身定做，在许多情况下，还需要一个多学科的专家团队。如果要避免上尿路和下尿路不可逆转的恶化，及时的诊断和治疗是至关重要的。治疗决定是在综合医学评估的基础上做出的，包括尿动力学以确定功能障碍的类型。调查技术的进步促进了对NLUTD患者的非侵入性和保守性治疗。结论：NLUTD的诊断和治疗是一个高度专业化和复杂的领域，涉及泌尿外科和内科，需要随时获得最新的专家意见。目前的指导方针就是为了满足这一需要。(C)2009年欧洲泌尿外科协会。爱思唯尔出版，版权所有。
Context: Most patients with neurogenic lower urinary tract dysfunction (NLUTD) require life-long care to maintain their quality of life (QoL) and to maximise life expectancy.Objective: To provide a summary of the 2008 version of the European Association of Urology (EAU) guidelines on NLUTD and to assess the effectiveness of currently available diagnostic tools, particularly ultrasound imaging and urodynamics.Evidence acquisition: The recommendations provided in the 2008 EAU guidelines on NLUTD are based on a review of the literature, using online searches of Medline and other source documents published between 2004 and 2007. A level of evidence and/or a grade of recommendation have been assigned to the guidelines where possible.Evidence synthesis: NLUTD encompasses a wide spectrum of pathologies, and patients often require life-long, intensive medical care to maximise their life-expectancy and to maintain their QoL. Treatment must be tailored to the needs of the individual patient and, in many cases, involves a multidisciplinary team of experts. Timely diagnosis and treatment are essential if irreversible deterioration of both the upper and lower Urinary tracts are to be avoided. Therapeutic decisions are made on the basis of a comprehensive medical assessment, including urodynamics to identify the type of dysfunction. Advances in investigative technologies have facilitated the noninvasive and conservative management of patients who have NLUTD.Conclusions: The diagnosis and treatment of NLUTD, which is a highly specialised and complex field involving both urology and medicine, requires up-to-date expert advice to be readily available. The current guidelines are designed to fulfil this need. (C) 2009 European Association of Urology. Published by Elsevier B.V. All rights reserved.