The management of lower urinary tract symptoms in men

Rees, Jonathan; Bultitude, Matthew; Challacombe, Benjamin

doi:10.1136/bmj.g3861

Cited by 26 publications

(14 citation statements)

References 215 publications

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“… 3 However, the latest evidence from epidemiological studies suggests that these symptoms are actually associated with LUTS. 2 Several community-based studies have also shown strong correlations between the prevalence of sexual dysfunction, especially erectile dysfunction, and the severity of LUTS with increasing age. 4 …”

Section: Introductionmentioning

confidence: 99%

“…LUTS are common in men and have been shown to have increased frequency and severity with age. 2 Symptoms of male sexual dysfunction, including erectile dysfunction, ejaculatory dysfunction, and hypoactive desire were previously assumed to be only natural consequences of aging. 3 However, the latest evidence from epidemiological studies suggests that these symptoms are actually associated with LUTS.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and factor association of premature ejaculation among adult Asian males with lower urinary tract symptoms

Silangcruz

Chua

Morales

2015

Prostate International

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PurposeTo determine the prevalence of premature ejaculation (PE) among adult Asian males presented with lower urinary tract symptoms (LUTS) and characterize its association with other clinical factors.MethodsA cross-sectional study was conducted at a tertiary medical center to determine the prevalence of PE among adult male participants with LUTS during the Annual National Prostate Health Awareness Day. Basic demographic data of the participants were collected. All participants were assessed for the presence and severity of LUTS using the International Prostate Symptom Score (IPSS), and for the presence of PE using the PE diagnostic tool. Digital rectal examination was performed by urologists to obtain prostate size. LUTS was further categorized into severity, storage symptoms (frequency, urgency, and nocturia), and voiding symptoms (weak stream, intermittency, straining, and incomplete emptying) to determine their association with PE. Data were analyzed by comparing the participants with PE (PE diagnostic tool score ≥11) versus those without PE, using the independent t test for continuous data, Mann–Whitney U test for ordinal data, and Chi-square test for nominal data. The statistical significance was set at P < 0.05.ResultsA total of 101 male participants with a mean ± standard deviation age of 60.75 ± 10.32 years were included. Among the participants, 33% had moderate LUTS, and 7% severe LUTS. The most common LUTS was nocturia (33%). The overall prevalence of PE was 27%. There was no significant difference among participants with PE versus those without PE in terms of age, marital status, prostate size, or total IPSS score. However, significant difference between groups was noted on the level of education (Mann–Whitney U, z = −1.993, P = 0.046) where high educational status was noted among participants with PE. Likewise, participants with PE were noted to have more prominent weak stream (Mann–Whitney U, z = −2.126, P = 0.033).ConclusionsAmong the participants consulted with LUTS, 27% have concomitant PE. Educational status seems to have an impact in the self-reporting of PE, which may be due to a higher awareness of participants with higher educational attainment. A significant association between PE and weak stream that was not related to prostate size suggests a neuropathologic association.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence and factor association of premature ejaculation among adult Asian males with lower urinary tract symptoms

Silangcruz

Chua

Morales

2015

Prostate International

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“…Benign prostatic hyperplasia (BPH), characterised by lower urinary tract symptoms (LUTS), is highly prevalent among ageing men, with more than one‐third of those aged 50 years or over experiencing moderate‐to‐severe LUTS . The symptoms of BPH are known to substantially impair the quality of life for patients .…”

Section: Introductionmentioning

confidence: 99%

Comparison of the clinical effect of dutasteride therapy for benign prostatic hyperplasia when initiated at different time points: A multicentre, observational, retrospective chart review study

et al. 2019

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Summary Aim To evaluate the effects of early (≤6 months after starting any medical treatment [baseline] for benign prostatic hyperplasia [BPH]), intermediate (between >6 months and 2 years from baseline) and late (2 years after baseline) initiation of add‐on dutasteride therapy on the incidence of acute urinary retention (AUR) and BPH‐related surgery in Japanese patients with moderate‐to‐severe BPH. Methods This multicentre, observational, retrospective chart review study used anonymised data from Japanese medical records. Eligible patients (≥50 years) were followed from baseline until first AUR, BPH‐related surgery or Year 4. Results Overall, 1206 patients were included (early initiation: n = 793; intermediate: n = 233; late: n = 180). Early dutasteride initiation was not superior to late initiation in reducing the risk of first AUR or BPH‐related surgery from baseline (hazard ratio [HR] 0.733; 95% confidence interval [CI] 0.468‐1.150) but was superior in reducing the risk of first AUR alone (HR 3.449; 95% CI 1.796‐6.623). One year after initiation, the cumulative incidence of first AUR rose rapidly in the late vs early and intermediate initiation groups. Incidences of all parameters (first AUR/BPH‐related surgery, first AUR alone and BPH‐related surgery alone) in patients undergoing BPH‐related surgery in low incidence sites (ie clinical sites with ≤ 16% incidence of first AUR or BPH‐related surgery) were significantly lower in the early vs late initiation groups. Conclusion Early dutasteride initiation reduced the risk of AUR in a Japanese real‐world setting. A randomised controlled trial is warranted to evaluate the benefit of early initiation in preventing BPH‐related surgery in Japanese patients.

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“…10 Post-micturition dribble is a sign of urine in the bulbar urethra that is not fully expelled. 8 Ask about symptom duration; a sudden change may indicate bladder pathology such as a urinary tract infection or bladder malignancy.…”

Section: What You Should Covermentioning

confidence: 99%