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A practical approach to the management of lower urinary tract symptoms among men
Author(s) -
Woo Henry H,
Gillman Michael P,
Gardiner Robert,
Marshall Villis,
Lynch William J
Publication year - 2011
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2011.tb03185.x
Subject(s) - medicine , lower urinary tract symptoms , overactive bladder , pharmacotherapy , watchful waiting , urology , benign prostatic hyperplasia (bph) , quality of life (healthcare) , erectile dysfunction , urinary system , medical therapy , prostate , pathology , alternative medicine , nursing , cancer , prostate cancer
Lower urinary tract symptoms (LUTS) are common among Australian men over the age of 45 years; most men with LUTS will have benign prostatic hyperplasia (BPH), overactive bladder (OAB), or both. The cause of LUTS should be diagnosed by assessing symptom severity and excluding of medical or pharmaceutical causes. All men with LUTS should undergo digital rectal examination; other diagnostic tools include urine and blood testing, voiding charts and imaging. Depending on disease severity, impact on quality of life, patient preference, presence of complications and fitness for surgery, BPH is managed with watchful waiting, pharmacotherapy (α‐blockers or 5‐α‐reductase inhibitors), minimally invasive surgical therapies or surgery. OAB is initially treated with behavioural therapy; if this is ineffective, pharmacotherapy (usually antimuscarinics) can be used. Patients with LUTS with a provisional diagnosis other than BPH or OAB, or with complications or poor response to pharmacotherapy, should be referred to a urologist.