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LUTS treatment: future treatment options.

K-E Andersson¹

¹Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina 27157, USA. Karl-Eric.Andersson@med.lu.se

Neurourology and Urodynamics

|August 19, 2007

Summary

Lower urinary tract symptoms (LUTS) impact both men and women, shifting treatment focus beyond the prostate. Emerging therapies offer new hope for managing these diverse bladder conditions.

Area of Science:

Urology
Pharmacology

Background:

Lower urinary tract symptoms (LUTS) encompass storage, voiding, and postmicturition issues, affecting both sexes.
While historically linked to benign prostatic hyperplasia (BPH) in men, LUTS are not exclusively prostate-related, prompting a shift in treatment focus to the bladder and other extraprostatic sites.
Overactive bladder (OAB) symptoms, often linked to detrusor overactivity, are a significant component of LUTS.

Purpose of the Study:

To review traditional and novel therapeutic principles for managing LUTS.
To explore the potential of new pharmacological agents targeting various receptor sites and pathways.

Main Methods:

Literature review of established and emerging treatments for LUTS.
Analysis of pharmacological agents including alpha(1)-adrenoceptor antagonists, 5alpha-reductase inhibitors, phytotherapy, and novel drug classes.

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Main Results:

Traditional treatments for LUTS suggestive of BPH include alpha(1)-adrenoceptor antagonists, 5alpha-reductase inhibitors, and phytotherapy.
Promising new therapeutic agents include selective beta(3)-adrenoceptor agonists and antimuscarinics, particularly for storage symptoms.
Other significant agents under investigation include P2X(3) receptor antagonists, botulinum toxin type A, endothelin-converting enzyme inhibitors, and drugs targeting vanilloid, angiotensin, and vitamin D(3) receptors.

Conclusions:

The therapeutic landscape for LUTS is evolving, with a move towards targeting bladder function and extraprostatic mechanisms.
Novel pharmacological approaches, including selective beta(3)-adrenoceptor agonists and agents acting on diverse receptor systems, show significant promise for LUTS management.
Further research into drugs affecting the nitric oxide/cGMP-cAMP pathway, Rho-kinase, COX, and central nervous system targets is warranted for comprehensive LUTS treatment.