Lower urinary tract symptoms - current management in older men

Area of Science:

• Urology
• Geriatrics
• Men's Health

Background:

• Lower urinary tract symptoms (LUTS) are prevalent in men, with incidence increasing with age.
• Understanding LUTS is crucial for managing men's health, particularly in older populations.

Purpose of the Study:

• To provide an updated overview of the evaluation and treatment of LUTS in older men.
• To detail current nomenclature, diagnostic approaches, and therapeutic strategies for LUTS.

Main Methods:

• Review of current medical literature on LUTS evaluation and management.
• Description of diagnostic tools, including the International Prostate Symptom Score (IPSS).
• Summary of available medical (alpha-blockers, 5-ARIs, antimuscarinics) and surgical treatments.

Main Results:

• LUTS can be categorized into voiding (e.g., weak stream, hesitancy) and storage (e.g., frequency, urgency) symptoms.
• Enlarged prostate commonly causes voiding symptoms, while detrusor overactivity may cause storage symptoms.
• The International Prostate Symptom Score aids in symptom assessment and treatment response monitoring.

Conclusions:

• Early urological referral is indicated for specific red flags like haematuria, recurrent infections, or urinary retention.
• Medical therapy can be initiated in primary care for uncomplicated LUTS.
• Urological referral is necessary if symptoms persist despite medical treatment or if medical therapy is not tolerated.