Benign prostatic hyperplasia and lower urinary tract symptoms. A review of current evidence

Actas Urol Esp. 2016 Jun;40(5):288-94. doi: 10.1016/j.acuro.2015.12.008. Epub 2016 Jan 25.
[Article in English, Spanish]

Abstract

Context: The treatment of benign prostatic hyperplasia (BPH) is changing due to a greater understanding of the disease and the development of the functional concept of lower urinary tract symptoms (LUTS).

Objectives: To describe the current state of BPH and the diagnosis and treatment of LUTS.

Acquisition of evidence: We summarise the issues presented and debated by a group of expert urologists during the First UROVI Congress, sponsored by the Spanish Urological Association.

Summary of the evidence: LUTS encompasses filling, voiding and postvoiding symptoms that affect patients' quality of life. The aetiological diagnosis is an important element in starting the most ideal treatment. For this reason, new alternative therapies (both pharmacological and surgical) are needed to help individually address the symptoms in the various patient profiles. There is now a new combination of drugs (6mg of solifenacin and 0.4mg of the tamsulosin oral controlled absorption system) for treating moderate to severe filling symptoms and emptying symptoms associated with BPH in patients who do not respond to monotherapy. Furthermore, new surgical techniques that are increasingly less invasive help provide surgical options for older patients and those with high comorbidity.

Conclusions: The availability of drugs that can act on the various LUTS helps integrate the pathophysiological paradigm into the functional one, providing more appropriate treatment for our patients.

Keywords: Benign prostatic hyperplasia; Hiperplasia benigna de próstata; Lower urinary tract symptoms; Síntomas del tracto urinario inferior.

Publication types

  • Review

MeSH terms

  • Humans
  • Lower Urinary Tract Symptoms / diagnosis*
  • Lower Urinary Tract Symptoms / etiology
  • Lower Urinary Tract Symptoms / therapy*
  • Male
  • Prostatic Hyperplasia / complications
  • Prostatic Hyperplasia / diagnosis*
  • Prostatic Hyperplasia / therapy*