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Review
. 2017 Jan-Mar;29(1):6-11.
doi: 10.4103/tcmj.tcmj_3_17.

Current consensus and controversy on the diagnosis of male lower urinary tract symptoms/benign prostatic hyperplasia

Cheng-Ling Lee  1 , Hann-Chorng Kuo  1
Affiliations
Review

Current consensus and controversy on the diagnosis of male lower urinary tract symptoms/benign prostatic hyperplasia

Cheng-Ling Lee et al. Tzu Chi Med J. 2017 Jan-Mar.

Abstract

Traditionally, male lower urinary tract symptoms (LUTS) have been considered a synonym for benign prostate hyperplasia (BPH) because most male LUTS develops in aging men. Medical treatment should be the first-line treatment for BPH and surgical intervention should be performed when there are complications or LUTS refractory to medical treatment. Recent investigations have revealed that bladder dysfunction and bladder outlet dysfunction contribute equally to male LUTS. In the diagnosis of LUTS suggestive of BPH (LUTS/BPH), the following questions should be considered: Is there an obstruction? Are the LUTS caused by an enlarged prostate? What are the appropriate tools to diagnose an obstructive BPH? Should patients with LUTS be treated before bladder outlet obstruction is confirmed? This article discusses the current consensus and controversies in the diagnosis of LUTS/BPH.

Keywords: Lower urinary tract symptoms; Medical treatment; Overactive bladder; Quality of life; Surgery.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
The diagnostic and treatment algorithm for male LUTS/BPH (LUTS = Lower urinary tract symptoms; BPH = Benign prostatic hyperplasia; IPSS = International Prostate Symptom Score; DRE = Digital rectal examination; PVR = Postvoid residual; TPV = Total prostate volume; PSA = Prostatic specific antigen; VUDS = Videourodynamic study; BPO = Benign prostatic obstruction; BND = Bladder neck dysfunction; PRES = Poor relaxation of the external sphincter; LUTD = Lower urinary tract dysfunction; OAB = Overactive bladder; DHIC = Detrusor hyperactivity and inadequate contractility; DU = Detrusor underactivity; TUI-BN = Transurethral incision of bladder neck; TURP = Transurethral resection of the prostate; 5ARI: 5-alpha-reductase inhibitor
See this image and copyright information in PMC

References

    1. Milsom I, Abrams P, Cardozo L, Roberts RG, Thüroff J, Wein AJ. How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int. 2001;87:760–6. - PubMed
    1. Eckhardt MD, van Venrooij GE, Boon TA. Symptoms, prostate volume, and urodynamic findings in elderly male volunteers without and with LUTS and in patients with LUTS suggestive of benign prostatic hyperplasia. Urology. 2001;58:966–71. - PubMed
    1. Boyle P, Gould AL, Roehrborn CG. Prostate volume predicts outcome of treatment of benign prostatic hyperplasia with finasteride: Meta-analysis of randomized clinical trials. Urology. 1996;48:398–405. - PubMed
    1. Neal DE, Ramsden PD, Sharples L, Smith A, Powell PH, Styles RA, et al. Outcome of elective prostatectomy. BMJ. 1989;299:762–7. - PMC - PubMed
    1. Chen JL, Kuo HC. Implications of prostatic volume measurements on the degree of bladder outlet obstruction in men with benign prostatic prostatic hyperplasia and lower urinary tract symptoms. JUTA. 2006;17:41–7.