Current consensus and controversy on the diagnosis of male lower urinary tract symptoms/benign prostatic hyperplasia

Abstract

Traditionally, male lower urinary tract symptoms (LUTS) have been considered a synonym for benign prostate hyperplasia (BPH) because most male LUTS develops in aging men. Medical treatment should be the first-line treatment for BPH and surgical intervention should be performed when there are complications or LUTS refractory to medical treatment. Recent investigations have revealed that bladder dysfunction and bladder outlet dysfunction contribute equally to male LUTS. In the diagnosis of LUTS suggestive of BPH (LUTS/BPH), the following questions should be considered: Is there an obstruction? Are the LUTS caused by an enlarged prostate? What are the appropriate tools to diagnose an obstructive BPH? Should patients with LUTS be treated before bladder outlet obstruction is confirmed? This article discusses the current consensus and controversies in the diagnosis of LUTS/BPH.

Lower urinary tract symptoms–Benign prostatic hyperplasia may increase the risk of subsequent inguinal hernia in a Taiwanese population: A nationwide population-Based cohort study

“…Benign prostatic hyperplasia (BPH) is one of the most common causes of male lower urinary tract symptoms (LUTS) and occurs with aging [22]. As LUTS-BPH progresses despite medical treatment, post void residual (PVR) and urinary tract infection can be identified requiring appropriate surgical intervention [23].…”

Real-world data and treatment patterns of patients with lower urinary tract symptoms due to benign prostatic hyperplasia in Germany: an observational study using health insurance claims data

“…Some patients may have been diagnosed with BPH based on radiological/ultrasonographic findings without any symptoms to substantiate the diagnosis. Alternatively, premature BPH coding may have occurred in patients presenting with LUTS in whom the underlying cause; however, may not be BPH-related [9,10].…”