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Related Experiment Videos

Overactive bladder in men: special considerations for evaluation and management.

Roger R Dmochowski1, David Staskin

  • 1Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA. roger.dmochowski@mcmail.vanderbilt.edu

Urology
|December 21, 2002
PubMed
Summary

Lower urinary tract symptoms (LUTS) in men, often linked to benign prostatic hyperplasia, require a graded diagnostic approach. Management should consider potential detrusor muscle contributions, especially in older men experiencing LUTS.

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Area of Science:

  • Urology
  • Geriatrics
  • Internal Medicine

Background:

  • Lower urinary tract symptoms (LUTS) in men commonly stem from conditions like benign prostatic hyperplasia.
  • LUTS can present with storage symptoms (urgency, frequency, urge incontinence), but their presence or absence doesn't definitively rule out overactive bladder (OAB) or outlet obstruction.

Purpose of the Study:

  • To outline an optimal diagnostic and management strategy for men experiencing LUTS.
  • To emphasize the importance of considering detrusor contributions in the context of aging and LUTS.

Main Methods:

  • Review of clinical presentations of LUTS, including storage and obstructive symptoms.
  • Correlation of symptomatic assessments with urodynamic findings.
  • Discussion of a graded diagnostic and therapeutic approach.

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Main Results:

  • Symptomatic correlates with urodynamic findings are strong for isolated overactive bladder symptoms.
  • Mixed presentations or obstructive scenarios show weaker correlations with standard symptom assessment tools.
  • A graded approach, reserving invasive evaluations for treatment failures or complex cases, is recommended.

Conclusions:

  • A graded diagnostic and management strategy is ideal for LUTS in men.
  • Detrusor contribution to LUTS increases with age and must be integrated into management.
  • Presumptive therapy and less invasive methods should precede more complex interventions.