TY - JOUR
T1 - Lower Urinary Tract Symptoms Revisited
T2 - A Broader Clinical Perspective
AU - Chapple, Christopher R.
AU - Wein, Alan J.
AU - Abrams, Paul
AU - Dmochowski, Roger R.
AU - Giuliano, François
AU - Kaplan, Steven A.
AU - McVary, Kevin T.
AU - Roehrborn, Claus
N1 - Funding Information:
Acknowledgement statement : The initial draft of this article was written by Christopher Chapple based on input from all the authors, amended by Alan Wein and Paul Abrams, and then the subsequent drafts were amended and commented on by all authors. In order to achieve this, editorial support was provided by Linda Merkel, PhD, of Complete Healthcare Communications, Inc, and was funded by Pfizer Inc. Additional comments and data clarification for epidemiologic data on EPIC and EpiLUTS were provided by Pfizer Inc.
PY - 2008/9
Y1 - 2008/9
N2 - Context: The term "lower urinary tract symptoms" (LUTS) was introduced to dissociate male urinary symptoms from any implied site of symptom origin, such as the prostate. Objective: To consider a more expansive view of LUTS, moving beyond an organocentric focus. Evidence acquisition: Review of the available literature by a consensus panel. Evidence synthesis: A consensus group reviewed the literature and developed a conceptual framework to facilitate research and clinical practice in patients with LUTS, following steps outlined in the Delphi procedure. Committee discussion, with presentations and review of existing literature and knowledge at four separate occasions, and extensive review and discussion of draft documents encapsulating group views followed. Consensus group findings included evidence that LUTS increase with age and are prevalent in both male and female patients, with differences in the prevalence of individual storage, voiding, and postmicturition symptoms representing underlying pathophysiologic factors between the sexes. Additionally, it was recognised that patients often have underlying and overlapping pathophysiologic mechanisms that may be related to the expression of LUTS and that this global approach to LUTS reflects our contemporary recognition of the lower urinary tract as an integrated functional unit. To improve the current management of patients, education and awareness regarding LUTS, its causes, and associated comorbidities are needed. Major limitations of this work are the potential interpretive bias introduced by prior perceptions and the nature of the study populations drawn conventionally from secondary care. Conclusions: In conclusion, it is misleading to attribute individual symptoms to sex differences or to a specific underlying organ. LUTS are a non-sex-specific, non-organ-specific group of symptoms, which are sometimes age-related and progressive. A need exists to increase education and awareness regarding LUTS, its causes, and associated comorbidities, and to assess and treat men and women for all LUTS, not just selected symptoms.
AB - Context: The term "lower urinary tract symptoms" (LUTS) was introduced to dissociate male urinary symptoms from any implied site of symptom origin, such as the prostate. Objective: To consider a more expansive view of LUTS, moving beyond an organocentric focus. Evidence acquisition: Review of the available literature by a consensus panel. Evidence synthesis: A consensus group reviewed the literature and developed a conceptual framework to facilitate research and clinical practice in patients with LUTS, following steps outlined in the Delphi procedure. Committee discussion, with presentations and review of existing literature and knowledge at four separate occasions, and extensive review and discussion of draft documents encapsulating group views followed. Consensus group findings included evidence that LUTS increase with age and are prevalent in both male and female patients, with differences in the prevalence of individual storage, voiding, and postmicturition symptoms representing underlying pathophysiologic factors between the sexes. Additionally, it was recognised that patients often have underlying and overlapping pathophysiologic mechanisms that may be related to the expression of LUTS and that this global approach to LUTS reflects our contemporary recognition of the lower urinary tract as an integrated functional unit. To improve the current management of patients, education and awareness regarding LUTS, its causes, and associated comorbidities are needed. Major limitations of this work are the potential interpretive bias introduced by prior perceptions and the nature of the study populations drawn conventionally from secondary care. Conclusions: In conclusion, it is misleading to attribute individual symptoms to sex differences or to a specific underlying organ. LUTS are a non-sex-specific, non-organ-specific group of symptoms, which are sometimes age-related and progressive. A need exists to increase education and awareness regarding LUTS, its causes, and associated comorbidities, and to assess and treat men and women for all LUTS, not just selected symptoms.
KW - Benign prostatic hyperplasia
KW - LUTS
KW - Lower urinary tract symptoms
KW - Storage
KW - Voiding
KW - assessment
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U2 - 10.1016/j.eururo.2008.03.109
DO - 10.1016/j.eururo.2008.03.109
M3 - Review article
C2 - 18423969
AN - SCOPUS:47949084996
SN - 0302-2838
VL - 54
SP - 563
EP - 569
JO - European urology
JF - European urology
IS - 3
ER -