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. 2022 Jul;82(1):60-70.
doi: 10.1016/j.eururo.2022.01.044. Epub 2022 Feb 16.

European Association of Urology Guidelines on the Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 2: Underactive Bladder, Bladder Outlet Obstruction, and Nocturia

Salvador Arlandis  1 , Kari Bø  2 , Hanny Cobussen-Boekhorst  3 , Elisabetta Costantini  4 , Monica de Heide  5 , Fawzy Farag  6 , Jan Groen  7 , Markos Karavitakis  8 , Marie Carmela Lapitan  9 , Margarida Manso  10 , Serenella Monagas Arteaga  11 , Arjun K Nambiar  12 , Aisling Nic An Riogh  13 , Eabhann O'Connor  14 , Muhammad Imran Omar  15 , Benoit Peyronnet  16 , Veronique Phé  17 , Vasileios I Sakalis  18 , Néha Sihra  19 , Lazaros Tzelves  20 , Mary-Lynne van Poelgeest-Pomfret  21 , Tine W L van den Bos  5 , Huub van der Vaart  22 , Christopher K Harding  23
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European Association of Urology Guidelines on the Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 2: Underactive Bladder, Bladder Outlet Obstruction, and Nocturia

Salvador Arlandis et al. Eur Urol. 2022 Jul.

Abstract

Context: Female lower urinary tract symptoms (LUTS) are a common presentation in urological practice. Thus far, only a limited number of female LUTS conditions have been included in the European Association of Urology (EAU) guidelines compendium. The new non-neurogenic female LUTS guidelines expand the remit to include these symptoms and conditions.

Objective: To summarise the management of underactive bladder (UAB), bladder outlet obstruction (BOO), and nocturia in females.

Evidence acquisition: The literature search was updated in September 2021 and evidence synthesis was conducted using modified GRADE approach as outlined for all EAU guidelines. A new systematic review on BOO was carried out by the panel for purposes of this guideline.

Evidence synthesis: The important considerations for informing guideline recommendations are presented, along with a summary of all the guideline recommendations.

Conclusions: Non-neurogenic female LUTS are an important presentation of urological dysfunction. Initial evaluation, diagnosis, and management should be carried out in a structured and logical fashion on the basis of the best available evidence. This guideline serves to present this evidence to practising urologists and other health care providers in an easily accessible and digestible format.

Patient summary: This report summarises the main recommendations from the European Association of Urology guideline on symptoms and diseases of the female lower urinary tract (bladder and urethra) not associated with neurological disease. We cover recommendations related to the treatment of underactive bladder, obstruction of the bladder outlet, and nighttime urination.

Keywords: Bladder outlet obstruction; Conservative management; European Association of Urology guidelines; Female lower urinary tracts symptoms; Nocturia; Underactive bladder.

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