Abstract：
OBJECTIVE: The European Association of Urology (EAU) Guidelines Panel on non-neurogenic male lower urinary tract symptoms (LUTS) aimed to develop a new subchapter on underactive bladder (UAB) in non-neurogenic men to inform health care providers of current best evidence and practice. Here, we present a summary of the UAB subchapter that is incorporated into the 2024 version of the EAU guidelines on non-neurogenic male LUTS.
METHODS: A systematic literature search was conducted from 2002 to 2022, and articles with the highest certainty evidence were selected. A strength rating has been provided for each recommendation according to the EAU Guideline Office methodology.
UNASSIGNED: Detrusor underactivity (DU) is a urodynamic diagnosis defined as a contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or failure to achieve complete bladder emptying within a normal time span. UAB is a terminology that should be reserved for describing symptoms and clinical features related to DU. Invasive urodynamics is the only widely accepted method for diagnosing DU. In patients with persistently elevated postvoid residual (ie, >300 ml), intermittent catheterization is indicated and preferred to indwelling catheters. Alpha-adrenergic blockers are recommended before more invasive techniques, but the level of evidence is low. In men with DU and concomitant benign prostatic obstruction (BPO), benign prostatic surgery should be considered only after appropriate counseling. In men with DU and no BPO, a test phase of sacral neuromodulation may be considered.
CONCLUSIONS: The current text represents a summary of the new subchapter on UAB. For more detailed information, refer to the full-text version available on the EAU website (https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts).
METHODS: A systematic literature search was conducted from 2002 to 2022, and articles with the highest certainty evidence were selected. A strength rating has been provided for each recommendation according to the EAU Guideline Office methodology.
UNASSIGNED: Detrusor underactivity (DU) is a urodynamic diagnosis defined as a contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or failure to achieve complete bladder emptying within a normal time span. UAB is a terminology that should be reserved for describing symptoms and clinical features related to DU. Invasive urodynamics is the only widely accepted method for diagnosing DU. In patients with persistently elevated postvoid residual (ie, >300 ml), intermittent catheterization is indicated and preferred to indwelling catheters. Alpha-adrenergic blockers are recommended before more invasive techniques, but the level of evidence is low. In men with DU and concomitant benign prostatic obstruction (BPO), benign prostatic surgery should be considered only after appropriate counseling. In men with DU and no BPO, a test phase of sacral neuromodulation may be considered.
CONCLUSIONS: The current text represents a summary of the new subchapter on UAB. For more detailed information, refer to the full-text version available on the EAU website (https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts).
摘要：
目的：欧洲泌尿外科协会（EAU）关于非神经性男性下尿路症状（LUTS）的指南小组旨在开发一个关于非神经性男性膀胱活动不足（UAB）的新章节，以告知医疗保健提供者当前的最佳证据和实践。这里,我们提供了UAB分章的摘要，该分章被纳入2024版的EAU关于非神经源性男性LUTS的指南中。
方法：从2002年至2022年进行了系统的文献检索，并选择了确定性最高的文章证据。根据EAU准则办公室方法，为每项建议提供了强度等级。
■逼尿肌活动不足（DU）是一种尿动力学诊断，定义为强度和/或持续时间降低的收缩，导致膀胱排空时间延长和/或无法在正常时间跨度内实现完全膀胱排空。UAB是一个术语，应保留用于描述与DU相关的症状和临床特征。侵入性尿动力学是唯一被广泛接受的诊断DU的方法。在持续升高的后空隙残留的患者中（即，>300毫升)，间歇性导尿是指征和首选留置导管。在更具侵入性的技术之前，建议使用α-肾上腺素能受体阻滞剂，但是证据水平很低。在患有DU和伴随良性前列腺梗阻（BPO）的男性中，只有经过适当的咨询后，才应考虑进行良性前列腺手术。在有DU和没有BPO的男人中，可以考虑骶骨神经调节的测试阶段。
结论：当前文本代表了关于UAB的新小节的摘要。有关更多详细信息，请参阅EAU网站上提供的全文版本（https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts）。
结果：这里介绍了欧洲泌尿外科协会关于非神经源性成年男性膀胱活动不足的指南。患者必须充分了解所有相关选择，和他们的主治医生一起，为他们决定最优的管理。
方法：从2002年至2022年进行了系统的文献检索，并选择了确定性最高的文章证据。根据EAU准则办公室方法，为每项建议提供了强度等级。
■逼尿肌活动不足（DU）是一种尿动力学诊断，定义为强度和/或持续时间降低的收缩，导致膀胱排空时间延长和/或无法在正常时间跨度内实现完全膀胱排空。UAB是一个术语，应保留用于描述与DU相关的症状和临床特征。侵入性尿动力学是唯一被广泛接受的诊断DU的方法。在持续升高的后空隙残留的患者中（即，>300毫升)，间歇性导尿是指征和首选留置导管。在更具侵入性的技术之前，建议使用α-肾上腺素能受体阻滞剂，但是证据水平很低。在患有DU和伴随良性前列腺梗阻（BPO）的男性中，只有经过适当的咨询后，才应考虑进行良性前列腺手术。在有DU和没有BPO的男人中，可以考虑骶骨神经调节的测试阶段。
结论：当前文本代表了关于UAB的新小节的摘要。有关更多详细信息，请参阅EAU网站上提供的全文版本（https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts）。
结果：这里介绍了欧洲泌尿外科协会关于非神经源性成年男性膀胱活动不足的指南。患者必须充分了解所有相关选择，和他们的主治医生一起，为他们决定最优的管理。
