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1Department of Urology, Weill Medical College of Cornell University, New York, New York, USA. chaikin@morristownurology.com
Current Opinion in Urology
|June 29, 2001
Summary
Lower urinary tract symptoms (LUTS) have diverse causes in both men and women. Understanding the specific pathophysiology is key to effective treatment, rather than relying on symptoms alone.
Area of Science:
- Urology
- Medical Science
Background:
- Lower urinary tract symptoms (LUTS) encompass both storage and emptying issues of the micturition cycle.
- Etiology is multifactorial in both sexes, with symptoms being poor indicators of underlying pathophysiology.
- Common causes include prostatic obstruction in men and hormonal changes or childbirth in women.
Purpose of the Study:
- To highlight the multifactorial nature of lower urinary tract symptoms.
- To emphasize the limitations of symptom-based diagnosis and empiric treatment.
- To advocate for pathophysiology-based treatment for improved patient outcomes.
Main Methods:
- Review of existing literature on lower urinary tract symptoms.
- Analysis of the etiological factors in male and female LUTS.
- Comparison of symptom-based versus pathophysiology-based treatment approaches.
Main Results:
- LUTS etiology is complex and often misattributed, particularly in men where obstruction is not always the primary cause.
- Detrusor overactivity is common in men, while sphincteric incontinence is prevalent in women.
- Current empiric treatments may fail due to unaddressed underlying causes.
Conclusions:
- Symptom presentation alone is insufficient for accurate diagnosis of LUTS.
- Pathophysiology-based treatment strategies are crucial for successful management of lower urinary tract symptoms.
- A deeper understanding of individual LUTS causes will enhance therapeutic efficacy.
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