Moving beyond BPH – A contemporary update on male LUTS

摘要

This insightful state-of-the-art article reviews lower uri- nary tract symptoms (LUTS) and their interface with “so- called” benign prostatic hyperplasia (BPH), in particular, emphasising that LUTS are not just related to the prostate. Highlighting the importance of looking beyond the symp- toms, beyond the prostate at not just the potential for a treatment, but rather at the underlying functional basis for the symptomatology. It is essential to take into account not only the patients’ LUTS, but their general medical history, drug history and comorbidities and to carefully evaluate patients with a voiding diary, particularly where nocturia is a_ significant symptom. It is now well- established that the term LUTS includes storage, voiding and post-micturition symptoms. In particular it is the storage symptoms that lead to the majority of patients with “BPH” presenting to see us as urologists. It has been recognised for over 40 years that the bladder is an unre- liable witness and that LUTS are not disease specific. Nevertheless, in 2017 there is still a tendency for the term “BPH” to be used as though it is a clinical condition, as is also the case for the storage symptoms designated by the term “overactive bladder symptom complex (OAB)”, when in fact, the terms descried a collection of relatively non disease specific symptoms.