title: A practical approach to the management of lower urinary tract symptoms among men.
abstract: 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.
authors: Sydney Urological Associates, Sydney Adventist Hospital, Sydney, NSW. hwoo@urologist.net.au
authors: Henry H
authors: HH
authors: Woo
authors: Michael P
authors: MP
authors: Gillman
authors: Robert
authors: R
authors: Gardiner
authors: Villis
authors: V
authors: Marshall
authors: William J
authors: WJ
authors: Lynch
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D001521:Behavior Therapy; D018450:Disease Progression; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D015995:Prevalence; D011470:Prostatic Hyperplasia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014554:Urination; D014555:Urination Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology*; D057832:Watchful Waiting
chemical_list: D058891:5-alpha Reductase Inhibitors; D000317:Adrenergic alpha-Antagonists; D018727:Muscarinic Antagonists