New concepts for the treatment of male lower urinary tract symptoms

New insights into how lower urinary tract symptoms (LUTS) develop in the presence (or absence) of benign prostatic hyperplasia (BPH) led to a change of terminology from BPH to LUTS, and to the revelation that several other (not only prostatic) molecular structures are of value in treating LUTS. This review aims to summarize what new we know about 'why the prostate grows large', and what kind of therapeutic implications that bears, and second to present several new compounds, which show promising results in preclinical testings in regards to LUTS.

Apart from the old concept of mainly hormone-dependent prostate growth, new concepts on BPH cause include genetic reasons, correlations with metabolic disorders, as well as an inflammatory origin. New pharmacological compound classes, which might be of value in treating LUTS, are transient receptor potential V member 1 antagonists, fatty acid amide hydrolase inhibitors, soluble guanylyl cyclase stimulators and activators, Rho-kinase inhibitors, and purinergic receptor antagonists.

New concepts on BPH cause show interesting approaches, but are still in early stages. They carry, however, the highest prospect to bring up causal treatments. Some new compounds related to LUTS are on the verge to switch 'from bench to bedside'.