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Lower urinary tract symptoms

All articles from this key word are listed below.

Volume 8, Supplement 4 Review Articles

Update on the American Urological Association Guidelines for the Treatment of Benign Prostatic Hyperplasia

Advances in Alpha-Blocker Therapy in the Management of Urological Disorders

Steven A Kaplan

The updated 2003 American Urological Association (AUA) Guidelines for the treatment of benign prostatic hyperplasia (BPH) are the culmination of an exhaustive effort predicated on scientifically accepted methods of reviewing the medical literature. In this second publication of the guidelines, a multidisciplinary panel reviewed a new meta-analysis of outcome data from the BPH literature from before and after 1994. The major differences between the 2 guidelines are the changes in our understanding of the biology of the prostate and the introduction of new therapies. The vast majority of randomized controlled trials, particularly with respect to minimally invasive therapies and progression of BPH, were performed after the release of the 1994 guidelines. Also, the most recent AUA panel carefully reviewed unpublished data to make the guidelines as timely as possible. Studies that were subsequently published included those on the value of combination medical therapy for BPH. The panel agreed on updated recommendations for the treatment of moderate-to-severe lower urinary tract symptoms associated with BPH, and diagnostic algorithms were revised. The durability and utility of the present guidelines should exceed that of its predecessor. [Rev Urol. 2006;8(suppl 4):S10-S17]

Benign prostatic hyperplasia Lower urinary tract symptoms Combination therapy 5-reductase inhibitors AUA Guidelines AUA Symptom Scores

Volume 8, Supplement 4 Review Articles

Alpha-Blockers for the Treatment of Prostatitis-Like Syndromes

Advances in Alpha-Blocker Therapy in the Management of Urological Disorders

J Curtis Nickel

Prostatitis is a common medical diagnosis. The etiology of this symptomatic syndrome can be an acute or chronic bacterial infection, a noninfectious initiator (the most common cause), or iatrogenic heat or radiation; the syndrome may coexist with benign prostatic hyperplasia. Alpha-blockers have a role in the treatment of the prostatitis syndromes. In Category I, acute bacterial prostatitis, a-blockers have been shown to possibly ameliorate obstructive and irritative voiding symptoms. In Category II, chronic bacterial prostatitis, a-blockers seem to reduce the risk of clinical and bacteriological recurrence. In Category III, chronic pelvic pain syndrome, a-blockers improve symptoms and quality of life. Alpha-blockers also seem to ameliorate the symptoms and reduce the risk of acute urinary retention in patients who suffer from either heat- or radiation-induced prostatic inflammation. Alpha-blockers improve lower urinary tract symptoms, including pain, in patients who are diagnosed with both prostatitis and benign prostatic hyperplasia. Evidence has proven there is definitely a role for a-blockers in the management of the prostatitis syndromes. [Rev Urol. 2006;8(suppl 4):S26-S34]

Benign prostatic hyperplasia Lower urinary tract symptoms Blockers Prostatitis syndromes CP/CPPS

Volume 8, Number 4 Meeting Reviews

Advances in the Treatment of Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia

Meeting Review

Claus G Roehrborn

Highlights from the 21st European Association of Urology Congress, April 5–8, 2006, Paris, France [Rev Urol. 2006;8(4):216-225]

Benign prostatic hyperplasia Nocturia Lower urinary tract symptoms Alfuzosin Prostatectomy PDE-5 inhibitors TURP Dutasteride Sexual dysfunction Acute urinary retention Chronic inflammatory infiltrates PVP High-energy transurethral microwave thermotherapy

Volume 8, Supplement 3 Review Articles

Safety and Efficacy of the Potassium-Titanyl-Phosphate Laser and Photoselective Vaporization of the Prostate for Benign Prostatic Hyperplasia

Photoselective Vaporization of the Prostate

Claus G Roehrborn

The currently commercially available 80-W potassium-titanyl-phosphate laser used for photoselective vaporization of the prostate in men with lower urinary tract symptoms and benign prostatic hyperplasia (BPH) is a safe and effective therapeutic alternative for a wide spectrum of prostate sizes and configurations. Efficacy data from multicenter prospective studies, comparative studies against other interventions, and single-center long-term outcomes suggest the efficacy to be at least equivalent to that of transurethral resection of the prostate, with a very good safety profile. New technological developments promise to further enhance the utility of this laser for application in BPH and urology. [Rev Urol. 2006;8(suppl 3):S16-S23]

Benign prostatic hyperplasia Lower urinary tract symptoms Potassium-titanyl-phosphate laser Laser prostatec-tomy Photoselective vaporization of the prostate

Volume 8, Supplement 3 Review Articles

The Next Generation In Laser Treatments and the Role of the GreenLight High-Performance System Laser

Photoselective Vaporization of the Prostate

Lasers have evolved over the past decade, with technical refinements that have resulted in a procedure that can achieve transurethral-like results in a safe and efficacious manner. The physics and characteristics of the laser light, such as wavelength and power densities, influence efficiency of treatment and safety profiles of various laser techniques and systems. The currently commercially available 80-W potassium-titanyl-phosphate laser used for photoselective vaporization of the prostate gland in men with lower urinary tract symptoms and benign prostatic hyperplasia has been shown to be a safe and effective therapeutic alternative for a wide spectrum of prostate sizes and configurations. Refinements based on clinical experience as well as progress in available technologies have produced an advanced system with improvements in beam quality and an increase in power to provide an increase in vaporization efficiency and flexibility in technique. The refinements require adjustments to current technique. The advanced technological developments enhance the utility of this laser for application in benign prostatic hyperplasia and urology. [Rev Urol. 2006;8(suppl 3):S24-S30]

Benign prostatic hyperplasia Lower urinary tract symptoms Laser prostatectomy Potassium-titanyl-phosphate laser Transurethral resection of the prostate

Volume 8, Number 3 Meeting Reviews

Best of the 2006 AUA Annual Meeting

Meeting Review

Arie S Belldegrun Claus G Roehrborn Michael K Brawer Jacob Rajfer John P Stein John P Mulhall Tobias Klatte Michael E Aldridge Li-Ming Su Shachi Tyagi Danil V Makarov Ellen Shapiro Alan W Partin Michael B Chancellor Victor W Nitti J Curtis Nickel

Highlights from the 2006 Annual Meeting of the American Urological Association May 20–25, 2006 Atlanta, GA

Prostate cancer Infertility Benign prostatic hyperplasia Bladder cancer Kidney cancer Lower urinary tract symptoms Bladder exstrophy Overactive bladder Interstitial cystitis Stress urinary incontinence Peyronie’s disease Spina bifida Neurogenic bladder Erectile dysfunction Chronic pelvic pain syndrome Chronic prostatitis Tumor markers Androgen replacement therapy Ejaculatory dysfunction Anorectal malformations Renal stones Robotic-assisted radical prostatectomy

Volume 9, Number 4 Review Articles

Alpha Blockers for the Treatment of Benign Prostatic Hyperplasia

Treatment Update

The evolution of alpha blocker therapy for benign prostatic hyperplasia (BPH) has focused on improving convenience and tolerability. Indications for treating BPH include reversing signs and symptoms or preventing progression of the disease. The indication that most commonly drives the need for intervention is relief of lower urinary tract symptoms (LUTS) with the intent of improving quality of life. Alpha blockers are the most effective, least costly, and best tolerated of the drugs for relieving LUTS. Four long-acting alpha 1 blockers are approved by the Food and Drug Administration for treatment of symptomatic LUTS/BPH: terazosin, doxazosin, tamsulosin, and alfuzosin. All are well tolerated and have comparable dose-dependent effectiveness. Tamsulosin and alfuzosin SR do not require dose titration. Alfuzosin, terazosin, and doxazosin have all been shown to be effective in relieving LUTS/BPH independent of prostate size. [Rev Urol. 2007;9(4):181-190]

Benign prostatic hyperplasia Lower urinary tract symptoms Quality of life Tamsulosin Alfuzosin Doxazosin Terazosin

Volume 9, Number 3 Meeting Reviews

Best of the 2007 AUA Annual Meeting

Meeting Review

Claus G Roehrborn Michael K Brawer Michael B Chancellor Danil V Makarov Ellen Shapiro Alan W Partin Dean G Assimos J Curtis Nickel Jacob Rajfer

Highlights from the 2007 Annual Meeting of the American Urological Association May 19-24, 2007 Anaheim, CA [Rev Urol. 2007;9(3):133-154]

Prostate cancer Obesity Benign prostatic hyperplasia Antibiotic prophylaxis Nocturia Lower urinary tract symptoms Botulinum toxin Prostate-specific antigen Biomarkers PCA3 Testosterone Urinary tract infections Urolithiasis Laser ablation Endourology Male voiding dysfunction LHRH antagonists Antimuscarinic agents Circumcision Repeat biopsy Human glandularkallikrein Expectant management CRISP-3 MSP Microvesseldensity Endoglin Survivin Telomeres Interleukin-8 PDE-5 inhibitors Acute urinaryretention 5Alpha-reductase inhibitors Doxazosin Finasteride Transurethral microwave thermotherapy TURP Perioperative blood loss Microbialbiofilms HIV Stem cell injection

Volume 9, Number 2 Review Articles

Phosphodiesterase Type 5 Inhibitors for the Treatment of Male Lower Urinary Tract Symptoms

Treatment Update

Ricardo R Gonzalez Steven A Kaplan

Both lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) and erectile dysfunction have a very high prevalence among aging men, and there is some clinical evidence that they may share a common pathophysiology. Consequently, several preliminary studies of phosphodiesterase type 5 inhibitors—sildenafil and tadalafil—have recently been conducted in men with concomitant erectile dysfunction and lower urinary tract symptoms to determine whether these agents are effective for the treatment of symptomatic BPH. These studies have demonstrated efficacy, both alone and in combination with an -blocker, in treating lower urinary tract symptoms along with sexual dysfunction. However, larger-scale randomized studies are necessary to determine long-term safety, efficacy, and cost effectiveness. [Rev Urol. 2007;9(2):73-77]

Benign prostatic hyperplasia Lower urinary tract symptoms Erectile dysfunction Tadalafil Sildenafil Phosphodiesterase type 5 inhibitors

Volume 10, Number 1 Review Articles

Current Medical Therapies for Men With Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia: Achievements and Limitations

Treatment Update

Claus G Roehrborn

Over the last 20 years, our understanding of the pathophysiology and symptomatology of men with lower urinary tract symptoms (LUTS) has become increasingly more sophisticated. With this increase in sophistication, our utilization of various medical therapies, either alone or in combination, has also increased the understanding of the roles of individual medications, combinations of medications, and the benefits of different types of intervention. The rapid decline of the use of transurethral resection of the prostate (TURP) and other surgical procedures for benign prostatic hyperplasia (BPH) in the 1990s is due in part to the introduction of medical therapy. This article reviews the current state of medical therapy for men with LUTS and highlights its promises and its current limitations. [Rev Urol. 2008;10(1):14-25]

Benign prostatic hyperplasia Medical therapy 5-Alpha-reductase inhibitors Lower urinary tract symptoms Alpha-adrenergic receptor blockers