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Review
. 2017 Dec 7;10(2):79-92.
doi: 10.1177/1756287217742837. eCollection 2018 Feb.

Best practice in the management of storage symptoms in male lower urinary tract symptoms: a review of the evidence base

Mauro Gacci  1 , Arcangelo Sebastianelli  2 , Pietro Spatafora  2 , Giovanni Corona  3 , Sergio Serni  2 , Dirk De Ridder  4 , Stavros Gravas  5 , Paul Abrams  6
Affiliations
Review

Best practice in the management of storage symptoms in male lower urinary tract symptoms: a review of the evidence base

Mauro Gacci et al. Ther Adv Urol. .

Abstract

Storage lower urinary tract symptoms (LUTS) are characterized by an altered bladder sensation, increased daytime frequency, nocturia, urgency and urgency incontinence. Some evidence underlines the role of metabolic factors, pelvic ischemia, prostatic chronic inflammation and associated comorbidities in the pathophysiology of storage LUTS. A detailed evaluation of the severity of storage LUTS, and the concomitance of these symptoms with voiding and postmicturition symptoms, is mandatory for improving the diagnosis and personalizing treatment. A detailed medical history with comorbidities and associated risk factors, a physical examination, a comprehensive analysis of all the features of LUTS, including their impact on quality of life, and a frequency-volume chart (FVC) or bladder diary, are recommended for men with storage LUTS. Several drugs are available for the treatment of LUTS secondary to benign prostatic obstruction (BPO). Alpha-blockers (α-blockers), 5-α-reductase inhibitors and phosphodiesterase type 5 inhibitors are commonly used to manage storage LUTS occurring with voiding symptoms associated with BPO. Muscarinic receptor antagonists and Beta 3-agonists (β3-agonists) alone, or in combination with α-blockers, represent the gold standard of treatment in men with predominant storage LUTS. There is no specific recommendation regarding the best treatment options for storage LUTS after prostatic surgery.

Keywords: BPH; LUTS therapy; antimuscarinics; benign prostatic enlargement; male LUTS; storage LUTS; β3-adrenoceptor agonist.

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Conflict of interest statement

Conflict of interest statement: The author(s) declared the following potential conflicts of interest with respect to the research, authorship or publication of this article: M Gacci: Consulting, honoraria, research support from Lilly, Bayer, Pfizer, Ibsa, GSK, Astellas, Pierre Fabre, Konpharma. D De Ridder: Consulting, honoraria, research support from Astellas, Medtronic, Axonics, Allergan. S Gravas: Consulting, honoraria, research support from Pierre Fabre Medicament, GSK, Astellas. P Abrams: Consulting, honoraria, research support from A Sebastianelli, P Spatafora and S Serni declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Prevalence of male storage lower urinary tract symptoms, data from epiLUTS survey.
Figure 2.
Figure 2.
Pathophysiological pathways underlying storage lower urinary tract symptoms. M3-R, muscarinic receptor 3; β3-AR, β3-adrenoceptor; α1D-AR, adrenergic receptor Alpha 1 D; A1a-AR, adrenergic receptor Alpha 1 A .
See this image and copyright information in PMC

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