Paul Abrams

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Paul Abrams

How do Male LUTS guide our management of Benign Prostatic Obstruction?

Wednesday 23rd October 2024

Thirty years ago, a British Medical Journal article introduced the term LUTS: “New words for old: lower urinary tract symptoms for prostatism”. The article also stressed the need for the correct use of the terms BPH, BPE and BPO. These proposals were adopted in the 2002 ICS Terminology report which has been cited more that 13,000 times. The term “prostatism” has thankfully disappeared. Despite this, men are still disadvantaged by the repetition of mantras stating or implying that the prostate is the cause of most male LUTS, and meaningless terms such as “LUTS due to BPH”, “LUTS due to BPE” and “Surgery for BPH” persist. This is disappointing and harmful to men as symptoms are still ascribed to the prostate when there are no proven associations between LUTS and the prostate which make them pathognomonic of BPO. Hence, men still undergo surgical treatment for LUTS when the cause(s) of the individuals LUTS are poorly investigated, and the other common causes of LUTS, such as overactive bladder and detrusor underactivity are not properly considered.

The ICS has led the way in terminology and urodynamic practice standards. However, much remains to be achieved. Men need to be fully informed as to what their doctors, including urologists, “know” as opposed to “believe” about LUTS management. They need to know that their assessment and treatment comes from an intellectually rigorous attitude by their doctors as to the cause(s) of their LUTS, and thereby will result in their LUTS being improved so that their quality of life is enhanced. Without such rigour, the risk that treatments are poorly selected is significant. Men need to be empowered with confidence as to when they can self-care and when they need medical intervention is needed.

ICS can lead the way.

View Paul Abrams' bio here

26/06/2024 19:49:25  26824
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