[The practice guideline 'Lower urinary-tract symptoms in middle-aged and elderly men' (second revision) from the Dutch College of General Practitioners; a response from the perspective of general practice].
Recent research has shown that the simple pathophysiological concept which explains micturition complaints in elderly men as being caused by benign prostatic hyperplasia needs to be abandoned. It has been shown that there is no clear correlation between prostate volume and voiding problems and also that reductase blocker drugs which specifically decrease prostate volume do not lead to a clinically important reduction in symptoms. The internationally accepted new conceptual umbrella description of these micturition problems is 'lower urinary-tract symptoms', a term that is more suited to research this area where a good understanding of the fundamental underlying mechanisms is lacking. The Dutch general practitioners' guideline for micturition problems in elderly men addresses this paradigm change in a thorough and easily understandable way.
Thomas
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Erasmus MC, afd. Huisartsgeneeskunde, Dr. Molewaterplein 50, 3015 GE Rotterdam.
D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010821:Physicians, Family / Q000592:standards*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011467:Prostate / Q000502:physiology*; D012955:Societies, Medical; D014553:Urinary Tract Physiological Phenomena; D014554:Urination; D014555:Urination Disorders / Q000628:therapy*