Evaluation and management of transient lower urinary tract symptoms (LUTS) after surgery for Benign prostatic...

The evaluation and management of lower urinary symptoms (LUTS) experienced in the immediate post-operative period after benign prostatic obstruction surgery (BPO), remain unclear. Aim of our study is to systematically report the evidence on management of post-operative transient urinary symptoms after BPO surgery.

A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist (PRISMA). PubMed, Embase, Scopus and Cochrane databases were searched up to March 2025. Studies evaluating pharmacotherapy, phytotherapy and/or physical treatment for post-operative transient LUTS in men aged were evaluated. Only randomized clinical trials (RCTs) were included.

Overall, nine RCTs were included. Among the surgical techniques investigated, most data were available for transurethral resection of the prostate. The methods used to assess post-operative LUTS, as well as the timing of evaluation, varied considerably across studies. The most commonly submitted questionnaire was the International Prostate Symptom Score, and the most frequently performed diagnostic tool was uroflowmetry. Anticholinergic drugs seems to have the greatest efficacy in improving post-operative LUTS, even if the level of evidence is low. In contrast, alpha-blockers did not appear to offer significant additional benefits in this setting of patients. Phytocomplexes (Graminex G63, Curcumin complexes) were effective in improving patients' quality of life (QoL) after BPO surgery. Pelvic floor muscle exercises (PFME) also demonstrated a reduction in symptom-related bother.

Current strategies for evaluating and managing transient postoperative LUTS are heterogeneous, and available evidence remains limited. Anticholinergic agents and phytotherapeutic compounds are among the most commonly prescribed treatments, though their efficacy is suboptimal. High-quality randomized trials are needed to provide robust clinical recommendations.