NHG-Richtlijnen
NHG-Standaard
M42
3.1
december 2022
april 2024
U. Urinewegen

Richtlijnen diagnostiek

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Lichamelijk onderzoek

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Aanvullend onderzoek

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Evaluatie

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Richtlijnen beleid

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Voorlichting

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Niet-medicamenteuze behandeling

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Medicamenteuze behandeling

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Controles

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Consultatie en verwijzing

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Beleid bij acute urineretentie

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Belangrijkste wijzigingen

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Kernboodschappen

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Inleiding

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Scope

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Buiten de scope

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Achtergronden

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Begrippen

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Aspecifieke mictieklachten

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Urineretentie

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Incontinentie

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Epidemiologie

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Pathofysiologie

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Natuurlijk beloop en prognose

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Richtlijnen diagnostiek

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Anamnese

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Lichamelijk onderzoek

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Vragenlijst en plasdagboek

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Aanvullend onderzoek

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Evaluatie

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Differentiaaldiagnose

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Richtlijnen beleid

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Voorlichting

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Niet-medicamenteuze behandeling

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Aspecifieke mictieklachten

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Bij urgency en incontinentie als belangrijkste klacht

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Bij nycturie als belangrijkste klacht

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Medicamenteuze behandeling

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Bij aspecifieke mictieklachten zonder urgency of nycturie als belangrijkste klacht

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Alfablokkers
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PDE-5-remmers (tadalafil)
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Praktische toepassing
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Niet-aanbevolen behandelingen bij aspecifieke mictieklachten
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Combinatiebehandeling alfablokker met 5-alfa-reductaseremmer
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Fytotherapie
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Bij urgency (met en zonder incontinentie) als belangrijkste klacht

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Muscarineantagonisten
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Selectieve bèta-3-agonisten (mirabegron)
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Combinatiebehandeling alfablokker en muscarineantagonist
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Praktische toepassing
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Bij nycturie als belangrijkste klacht

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Muscarineantagonisten
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Alfablokkers
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Niet aanbevolen behandelingen bij nycturie
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5-alfa-reductaseremmers
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PDE-5-remmers
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Mirabegron
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Desmopressine
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Lisdiuretica
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Invasieve behandeling

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Beleid bij acute urineretentie

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Katheterisatie

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Alfablokker na katheterisatie

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Controles

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Consultatie en verwijzing

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Referenties

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Keuzekaart - Problemen met plassen bij mannen zoals plas niet goed kunnen ophouden
Keuzekaart - Problemen met plassen bij mannen zoals zwakkere straal of nadruppelen
Urethrale katheter man; verwijderen en inbrengen
NHG-werkgroep:
Blanker MH, Bouthoorn SH, Greving JP, Klinkhamer S, Van der Does L, Van der Weele GM, Van Dijk N†, Weersma R, Wolters RJ
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