Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia (LUTS/BPH): More Than Treating Symptoms?
نویسنده
چکیده
Context: During the last two decades, it has becomeclear that the management of lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) is much more than just treating symptoms. Objective: This review paper gives an overview of the main factors influencing individual treatment decisions for LUTS/BPH patients. Evidence acquisition: This paper summarizes the content of an update lecture held during a symposium on the management of LUTS/BPH at the 2008 European Association of Urology meeting. During the presentation, the current decision drivers were discussed based upon recent literature and illustrated with the results of a Web-based survey evaluating urologists’ opinions on LUTS/BPH management. Evidence synthesis: The treatment of choice depends on the severity and type of LUTS, which are nowadays believed to have a multifactorial aetiology. Consequently, treatment for LUTS/BPH should not focus merely on the prostate, but also on other organs involved in disease pathogenesis. In addition, the progressive character of LUTS/BPH is an important driver when taking treatment decisions. Patients at low risk of disease progression require a fast and sustained symptom relief with minimal treatment morbidity, while patients at high risk of progression additionally require continuous treatment delaying LUTS/BPH progression and the development of complications. Therefore, clinicians should be able to determine a patient’s individual risk of progression. At present, seven baseline parameters and three dynamic variables have been identified as predictors of LUTS/BPH progression. Furthermore, as the quality of life (QoL) of both patients and their partners is severely affected by LUTS/BPH, this aspect should also be considered. Finally, treatment decisions are also influenced by existing comorbidities in the patient. Conclusions: Treatment for LUTS/BPH should aim at relieving the symptoms and especially at improving the patient’s QoL with minimal treatment morbidity. Furthermore, LUTS/BPH treatment should be adapted to the patient’s individual risk of disease progression. # 2008 European Association of Urology. Published by Elsevier B.V. All rights reserved.
منابع مشابه
Current consensus and controversy on the treatment of male lower urinary tract symptoms/benign prostatic hyperplasia
Lower urinary tract symptoms (LUTS) are highly prevalent in men and increase with age. Because LUTS are common among elderly men, they are usually considered synonymous with benign prostatic hyperplasia (BPH). Drugs should be the first-line treatment for BPH and surgical intervention should be performed only when there are complications or LUTS refractory to medical treatment. In addition to me...
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This study investigated the relationship of personality, depression, somatization, anxiety with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). The LUTS/BPH patients were evaluated with the International Prostate Symptom Score (IPSS), 44-item Big Five Inventory (BFI), the Patient Health Questionnaire-9 (PHQ-9), the PHQ-15, and 7-item Generalized Anxiety Disor...
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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 ...
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This is the first study to investigate the influence of depression, anxiety and somatization on the treatment response for lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). The LUTS/BPH patients were evaluated with the Korean versions of the International Prostate Symptom Score (IPSS), the Patient Health Questionnaire-9 (PHQ-9), the 7-item Generalized Anxiety Disorder Scale ...
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