title: Clinical Guideline for Female Lower Urinary Tract Symptoms.
abstract: The "Japanese Clinical Guideline for Female Lower Urinary Tract Symptoms," published in Japan in November 2013, contains two algorithms (a primary and a specialized treatment algorithm) that are novel worldwide as they cover female lower urinary tract symptoms other than urinary incontinence. For primary treatment, necessary types of evaluation include querying the patient regarding symptoms and medical history, examining physical findings, and performing urinalysis. The types of evaluations that should be performed for select cases include evaluation with symptom/quality of life (QOL) questionnaires, urination records, residual urine measurement, urine cytology, urine culture, serum creatinine measurement, and ultrasonography. If the main symptoms are voiding/post-voiding, specialized treatment should be considered because multiple conditions may be involved. When storage difficulties are the main symptoms, the patient should be assessed using the primary algorithm. When conditions such as overactive bladder or stress incontinence are diagnosed and treatment is administered, but sufficient improvement is not achieved, the specialized algorithm should be considered. In case of specialized treatment, physiological re-evaluation, urinary tract/pelvic imaging evaluation, and urodynamic testing are conducted for conditions such as refractory overactive bladder and stress incontinence. There are two causes of voiding/post-voiding symptoms: lower urinary tract obstruction and detrusor underactivity. Lower urinary tract obstruction caused by pelvic organ prolapse may be improved by surgery.
authors.affiliation: Department of Urology, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Urology, Harasanshin Hospital, Fukuoka, Japan.
authors.forename: Mineo
authors.initials: M
authors.lastname: Takei
authors.affiliation: Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Nishizawa
authors.affiliation: Division of Bioengineering and LUTD Research, School of Engineering, Nihon University, Koriyama, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Yamaguchi
authors.affiliation: Department of Female Urology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Kato
authors.affiliation: Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Momokazu
authors.initials: M
authors.lastname: Gotoh
authors.affiliation: Department of Urology, Yotsuya Medical Cube, Tokyo, Japan.
authors.forename: Yasukuni
authors.initials: Y
authors.lastname: Yoshimura
authors.affiliation: Urogynecology Center, Senboku-Fujii Hospital, Sakai, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Takeyama
authors.affiliation: Department of Urology, Kawasaki Hospital, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Ozawa
authors.affiliation: Department of Urology, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Shimada
authors.affiliation: Department of Urology, Continence Center, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yamanishi
authors.affiliation: Department of Urology, National Center for Geriatrics and Gerontology, Obu City, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Department of Urology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Hikaru
authors.initials: H
authors.lastname: Tomoe
authors.affiliation: Department of Urology, Faculty of Medical Science, University of Fukui, Fukui, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokoyama
authors.affiliation: Women's Lifecare Medicine, Department of Obstetrics & Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Masayasu
authors.initials: M
authors.lastname: Koyama
mesh_terms: D000465:Algorithms; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: clinical guidelines; female lower urinary tract symptoms