Abstract
Purpose of Review
The goal of this paper is to summarize existing literature on prevalence of lower urinary tract symptoms (LUTS) that may be attributed to benign prostatic hyperplasia (BPH, LUTS/BPH), factors associated with seeking treatment and treatment success, and subjective and objective methods of evaluating LUTS.
Recent Findings
Men primarily seek treatment for LUTS/BPH because bother overcomes barriers to treatment. Factors such as severity, bother, or persistence of symptoms primarily motivate individuals to seek treatment, while low-symptom severity mainly leads individuals to not seek treatment. Among men that seek treatment, nocturia and storage symptoms predominate. LUTS are assessed with self-report questionnaires; subjective evaluations translate moderately well to objective measurements of LUTS severity.
Summary
Current symptom classifications and patient groupings may be overly simplified and not evidence-based. Further studies evaluating novel symptom clusters and patient-centered BPH treatment approaches can guide future treatment.
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References
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Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol. 1984;132(3):474–9. https://doi.org/10.1016/s0022-5347(17)49698-4.
Irwin DE, Milsom IE, Hunskaar SE, Reilly K, Kopp Z, Herschorn S, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006;50(6):1306–15. https://doi.org/10.1016/j.eururo.2006.09.019.
Egan KB. The epidemiology of benign prostatic hyperplasia associated with lower urinary tract symptoms: prevalence and incident rates. Urol Clin North Am. 2016;43(3):289–97. https://doi.org/10.1016/j.ucl.2016.04.001.
Wei JT, Calhoun E, Jacobsen SJ. Urologic diseases in America project: benign prostatic hyperplasia. J Urol. 2005;173(4):1256–61. https://doi.org/10.1097/01.ju.0000155709.37840.fe.
Welliver C, Feinstein L, Ward JB, Fwu CW, Kirkali Z, Bavendam T, et al. Trends in lower urinary tract symptoms associated with benign prostatic hyperplasia, 2004 to 2013: the Urologic Diseases in America Project. J Urol. 2020;203(1):171–8. https://doi.org/10.1097/JU.0000000000000499.
Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2163–96. https://doi.org/10.1016/S0140-6736(12)61729-2.
• Welliver C, Sulaver R, Whittington A, et al. Analyzing why men seek treatment for lower urinary tract symptoms and factors associated with nonimprovement. Urology. 2015;86(5):862–7. https://doi.org/10.1016/j.urology.2015.08.006Study in LUTS/BPH men asking them to identify the primary symptom that led them to seek urologic care.
Pöyhönen A, Häkkinen JT, Koskimäki J, Hakama M, Tammela TLJ, Auvinen A. Prevalence of hesitancy in 30-80-year-old Finnish men: Tampere Ageing Male Urological Study (TAMUS). BJU Int. 2011;109(9):1360–4. https://doi.org/10.1111/j.1464-410x.2011.10443.x.
Peterson AC, Smith AR, Fraser MO, Yang CC, DeLancey J, Gillespie BW, et al. The distribution of post-void residual volumes in people seeking care in the symptoms of lower urinary tract dysfunction network observational cohort study with comparison to asymptomatic populations. Urology. 2019;130:22–8. https://doi.org/10.1016/j.urology.2019.01.069.
McVary KT, Peterson A, Donatucci CF, et al. Use of structural equation modeling to demonstrate the differential impact of storage and voiding lower urinary tract symptoms on symptom bother and quality of life during treatment for lower urinary tract symptoms associated with benign prostatic hyperplasia. J Urol. 2016;196(3):824–30. https://doi.org/10.1016/j.juro.2016.04.062.
Griffith JW, Messersmith EE, Gillespie BW, Wiseman JB, Flynn KE, Kirkali Z, et al. Reasons for seeking clinical care for lower urinary tract symptoms: a mixed methods study. J Urol. 2018;199(2):528–35. https://doi.org/10.1016/j.juro.2017.07.067.
Liu AB, Liu Q, Yang CC, Griffith JW, Smith AR, Helmuth ME, et al. Patient characteristics associated with more bother from lower urinary tract symptoms. J Urol. 2019;202(3):585–91. https://doi.org/10.1097/ju.0000000000000324.
Gacci M, Corona G, Sebastianelli A, Serni S, de Nunzio C, Maggi M, et al. Male lower urinary tract symptoms and cardiovascular events: a systematic review and meta-analysis. Eur Urol. 2016;70(5):788–96. https://doi.org/10.1016/j.eururo.2016.07.007.
•• Liu G, Andreev VP, Helmuth ME, et al. Symptom-based clustering of male participants in the symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) observational cohort study. J Urol. 2019;202(6):1230–9. https://doi.org/10.1016/j.juro.2018.02.2674Interesting study from the LURN group redefining LUTS patients into “clusters” instead of conventional symptom groups.
Amundsen CL, Helmuth ME, Smith AR, DeLancey JOL, Bradley CS, Flynn KE, et al. Longitudinal changes in symptom-based female and male LUTS clusters. Neurourol Urodyn. 2019;39(1):393–402. https://doi.org/10.1002/nau.24219.
Flynn KE, Mansfield SA, Smith AR, Gillespie BW, Bradley CS, Cella D, et al. Can 7- or 30-day recall questions capture self-reported lower urinary tract symptoms accurately? J Urol. 2019;202(4):770–8. https://doi.org/10.1097/ju.0000000000000310.
Weinfurt KP, Griffith JW, Flynn KE, Cella D, Bavendam T, Wiseman JB, et al. The comprehensive assessment of self-reported urinary symptoms: a new tool for research on subtypes of patients with lower urinary tract symptoms. J Urol. 2019;201(6):1177–83. https://doi.org/10.1097/ju.0000000000000140.
Cella D, Smith AR, Griffith JW, Kirkali Z, Flynn KE, Bradley CS, et al. A new brief clinical assessment of lower urinary tract symptoms for women and men: LURN SI-10. J Urol. 2020;203(1):164–70. https://doi.org/10.1097/ju.0000000000000465.
Taler SJ, Messersmith EE, Leichtman AB, Gillespie BW, Kew CE, Stegall MD, et al. Demographic, metabolic, and blood pressure characteristics of living kidney donors spanning five decades. Am J Transplant. 2013;13(2):390–8. https://doi.org/10.1111/j.1600-6143.2012.04321.x.
DeLancey JO, Fenner DE, Guire K, et al. Differences in continence system between community-dwelling black and white women with and without urinary incontinence in the EPI study. Am J Obstet Gynecol. 2010;202(6):P584.E1–584.E12. https://doi.org/10.1016/j.ajog.2010.04.027.
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Landau: none.
Welliver: Dr. Welliver reports consulting fees from Coloplast, personal fees from Oakstone Publishing, and personal fees from BMJ Best Practices, outside the submitted work.
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Landau, A., Welliver, C. Analyzing and Characterizing Why Men Seek Care for Lower Urinary Tract Symptoms. Curr Urol Rep 21, 58 (2020). https://doi.org/10.1007/s11934-020-01006-w
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DOI: https://doi.org/10.1007/s11934-020-01006-w