Benigne Prostatahyperplasie mit Blasenentleerungsstörung beim geriatrischen Patienten: Aktive (medikamentöse oder operative) Therapie vs. Katheterversorgung

Zusammenfassung

Epidemiologische Daten zeigen einen klaren Zusammenhang zwischen Alter, Prostatavergrößerung und den damit verbundenen Beschwerden. Das benigne Prostatasyndrom verläuft im Regelfall chronisch progredient und ein erheblicher Teil der BPS-Patienten, die vor der Entscheidung „konservative vs. chirurgische Therapie“ stehen sind hochbetagt und leiden oft an zahlreichen Komorbiditäten, sodass der Grundsatz des „nihil nocere“ besonders ernst zu nehmen ist. Die Nutzen-Risiko-Abschätzung ist sowohl bei der medikamentösen als auch bei der chirurgischen Therapie mit großer Sorgfalt vorzunehmen. Nach Sichtung der Literatur inclusive der einschlägigen Leitlinien kommt der Autor zu dem Schluss, dass es bei entsprechender Indikation kaum Gründe gibt, geriatrischen Patienten eine der zahlreichen interventionellen Optionen zu versagen, vielleicht mit der Ausnahme des tatsächlich bereits pflegebedürftigen Patientenkollektivs.

Abstract

Epidemiological data demonstrate a clear association between age, prostatic enlargement, and the associated symptoms. Benign prostatic syndromes usually take a chronic progressive course, and a significant share of BPS patients faced with the decision “conservative vs. surgical treatment” are of advanced age and suffer from numerous comorbidities, which means that the principle of “nihil nocere” must be given special consideration. A benefit-risk assessment must be carried out very carefully both for pharmacological and surgical treatment. Having reviewed the literature, including the relevant guidelines, the author concludes that, if a relevant indication exists, there are hardly any reasons to deny geriatric patients one of the numerous interventional options, perhaps with the exception of a patient population that is already in need of long-term care.

Schlüsselwörter

Benigne Prostatahyperplasie - geriatrischer Patient - Obstruktion - Therapie - Katheter

Keywords

geriatric patient - benign prostatic enlargement - treatment - indwelling catheter - obstruction

Publication History

Received: 02 April 2025

Accepted after revision: 28 April 2025

Article published online:
05 June 2025

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