Database: Ovid MEDLINE(R) <2006 to March Week 3 2010>
Search Strategy:
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1 lower urinary tract symptoms.mp. (1110)
2 lower urinary tract symptoms.ti. (436)
3 limit 2 to (english language and "review articles" and humans) (76)
4 limit 3 to full text (55)
5 limit 4 to yr=2008-current (28)
6 from 5 keep 1-28 (28)
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<1>
Unique Identifier
19846144
Status
MEDLINE
Authors
Sarma AV. Parsons JK. McVary K. Wei JT.
Authors Full Name
Sarma, Aruna V. Parsons, J Kellogg. McVary, Kevin. Wei, John T.
Institution
Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA.
Title
Diabetes and benign prostatic hyperplasia/lower urinary tract symptoms--what do we know?. [Review] [31 refs]
Source
Journal of Urology. 182(6 Suppl):S32-7, 2009 Dec.
Abstract
PURPOSE: Benign prostatic hyperplasia and associated lower urinary tract symptoms are highly prevalent in older men and represent a substantial challenge to public health. Apart from the prevalence of benign prostatic hyperplasia increasing with age, little is understood regarding its etiology and natural history. Increasing evidence recently pointed toward relationships between diabetes and benign prostatic hyperplasia/lower urinary tract symptoms. We present an overview of the current understanding of clinical and epidemiological research on diabetes and benign prostatic hyperplasia/lower urinary tract symptoms, the hypothesized pathophysiological mechanisms linking the conditions and recommendations for future directions for research. MATERIALS AND METHODS: A structured, comprehensive literature review was done to identify studies of the relationships between benign prostatic hyperplasia and lower urinary tract symptoms, and diabetes in older men. RESULTS: A substantial proportion of the existing body of literature supports an association between diabetes and benign prostatic hyperplasia/lower urinary tract symptoms. However, failure to differentiate lower urinary tract symptoms from benign prostatic hyperplasia contributed to some of the confusing evidence in studies including more specific benign prostatic hyperplasia measurements. This could be due in part to the largely cross-sectional analyses, the use of select or different study populations, limited sample sizes and inadequate control of potential confounders. CONCLUSIONS: Diabetes may substantially influence the risk of benign prostatic hyperplasia and lower urinary tract symptoms in older men. Further prospective, longitudinal analyses of the impact of diabetes and its etiological mechanisms on benign prostatic hyperplasia/lower urinary tract symptoms may identify novel interventions to prevent, diagnose and treat these highly prevalent conditions. [References: 31]
Publication Type
Journal Article. Review.
<2>
Unique Identifier
19942050
Status
MEDLINE
Authors
Le BV. Schaeffer AJ.
Authors Full Name
Le, Brian V. Schaeffer, Anthony J.
Institution
Department of Urology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
Title
Genitourinary pain syndromes, prostatitis, and lower urinary tract symptoms. [Review] [58 refs]
Source
Urologic Clinics of North America. 36(4):527-36, vii, 2009 Nov.
Abstract
The overlap of pain and urinary voiding symptoms is common for urologic patients. The etiology of these syndromes is frequently multifactorial and due to disorders of the bladder and/or prostate. The evaluation and treatment of these syndromes continues to evolve. Here we summarize the general approach to evaluation and treatment of these pain syndromes. [References: 58]
Publication Type
Journal Article. Research Support, N.I.H., Extramural. Review.
<3>
Unique Identifier
19942048
Status
MEDLINE
Authors
Donnell RF.
Authors Full Name
Donnell, Robert F.
Institution
The Department of Urology, The Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA.
Title
Minimally invasive therapy of lower urinary tract symptoms. [Review] [96 refs]
Source
Urologic Clinics of North America. 36(4):497-509, vi-vii, 2009 Nov.
Abstract
The establishment of guidelines, pharmacologic therapies, improved understanding of lower urinary tract symptoms (LUTS) versus benign prostate hyperplasia (BPH), respect for patient-centered goals, and improved discrimination of the patient with occult prostate cancer have empowered change in the management of LUTS. These developments have allowed urologists to recognize the limitations of transurethral prostatectomy as the gold standard and search for "ideal therapies" to provide treatments with an improved relief of symptoms, decreased complication rate and cost, to correct BPH-associated morbidities and prevent future morbidities. Prognostic parameters and their ability to predict progression may be important in the future of LUTS management and selection of therapy. [References: 96]
Publication Type
Journal Article. Review.
<4>
Unique Identifier
19942043
Status
MEDLINE
Authors
Mehdizadeh JL. Leach GE.
Authors Full Name
Mehdizadeh, Jennifer L. Leach, Gary E.
Institution
Tower Urology, CA, USA.
Title
Role of invasive urodynamic testing in benign prostatic hyperplasia and male lower urinary tract symptoms. [Review] [56 refs]
Source
Urologic Clinics of North America. 36(4):431-41, v, 2009 Nov.
Abstract
The role of urodynamics in the evaluation of lower urinary tract symptoms in men with benign prostatic hyperplasia is controversial despite the additional information regarding bladder function and outlet obstruction it provides. This controversy is primarily based on outcome studies that suggest men without proved bladder outlet obstruction may benefit from outlet reduction with medication or surgical resection. The aim of this article is to describe the role of urodynamic studies in the evaluation of benign prostatic hyperplasia, including illustration of existing urodynamic techniques, reviewing best practice guidelines and current literature, and providing recommendations for use of urodynamics in clinical practice. [References: 56]
Publication Type
Journal Article. Review.
<5>
Unique Identifier
19239452
Status
MEDLINE
Authors
Roumeguere T. Zouaoui Boudjeltia K. Hauzeur C. Schulman C. Vanhaeverbeek M. Wespes E.
Authors Full Name
Roumeguere, Thierry. Zouaoui Boudjeltia, K. Hauzeur, Claude. Schulman, Claude. Vanhaeverbeek, Michel. Wespes, Eric.
Institution
Laboratory of Experimental Medicine, CHU Charleroi, ULB, Montigny -le -Tilleul, Belgium.
Title
Is there a rationale for the chronic use of phosphodiesterase-5 inhibitors for lower urinary tract symptoms secondary to benign prostatic hyperplasia?. [Review] [67 refs]
Source
BJU International. 104(4):511-7, 2009 Aug.
Abstract
OBJECTIVES: To critically review the physiological roles of phosphodiesterase-5 (PDE5), to explain and support the putative impact and clinical significance of PDE5 inhibitors (PDE5-Is) in the treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) and erectile dysfunction (ED), both highly prevalent in men aged > or =50 years, as PDE5-Is are very effective as a first-line therapy for ED, and attractive for further physiological functional investigations. METHODS: We searched Medline for peer-reviewed articles in English, from 1991 to 2008, to provide a critical contemporary review of PDE5 pertaining to the potential interest of findings supporting a role for PDE5-Is in LUTS due to BPH. The selection of papers was based on the relevance of subject matter. A critical analysis of available fundamental and clinical data is reported. RESULTS: Several studies assessed the role of the nitric oxide/cGMP signalling pathway in the regulation of the prostate tone, with the support of clinical observations. PDE5-Is can also represent a potential mode of action allowing the targeting of transcriptional activity implicated in the regulation of the progression of the inflammatory process involved in BPH. PDE5-Is can inhibit human stromal cell proliferation of the prostate mediated by cGMP accumulation. New targeting hypotheses of pathophysiological processes are also reported. CONCLUSIONS: There is evidence that LUTS and ED are strongly linked. This analysis of the regulatory basis of PDE5 biology could indicate several directions of investigation. However, it is necessary to devise well-designed large prospective studies that would produce significant data before this approach becomes a standard of care. [References: 67]
Publication Type
Journal Article. Review.
<6>
Unique Identifier
19570484
Status
MEDLINE
Authors
MongiuAK. McVary KT.
Authors Full Name
Mongiu, Anne K. McVary, Kevin T.
Institution
Department of Urology, Northwestern UniversityFeinbergSchool of Medicine, Chicago, IL60611, USA.
Title
Lower urinary tract symptoms, benign prostatic hyperplasia, and obesity. [Review] [51 refs]
Source
Current Urology Reports. 10(4):247-53, 2009 Jul.
Abstract
Obesity has emerged as a global public health challenge. During the past 20 years, there has been a dramatic increase in obesity in the United States. In 2007, only one state had a prevalence of obesity less than 20%. In this growing epidemic of national concern is an emerging relationship between lower urinary tract symptoms (LUTS), benign prostatic hyperplasia (BPH), and obesity. BPH is the most common neoplastic condition afflicting men and constitutes a major factor impacting the health of the American male. Associations among obesity, physical inactivity, and BPH/LUTS resulting from epidemiological studies have not been explored via clinical trial methodology. A review of the available data appears to support a strong independent relationship between obesity and BPH/LUTS. This review also indicates that gene expression within the prostate varies with prostate size and can be affected by lifestyle modifications. Future studies may lead to office detection of a patient's particular polymorphisms, which may help guide individual treatment and lifestyle modifications that are more likely to succeed. [References: 51]
Publication Type
Journal Article. Review.
<7>
Unique Identifier
19444118
Status
MEDLINE
Authors
Milsom I.
Authors Full Name
Milsom, Ian.
Institution
Department of Obstetrics and Gynecology, SahlgrenskaAcademy at GothenburgUniversity, SahlgrenskaUniversityHospital, Gothenburg, Sweden.
Title
Lower urinary tract symptoms in women. [Review] [43 refs]
Source
Current Opinion in Urology. 19(4):337-41, 2009 Jul.
Abstract
PURPOSE OF REVIEW: To summarize recent population-based literature on the prevalence and consequences of urinary incontinence and overactive bladder (OAB) symptoms in women and describe our present knowledge regarding known risk factors. RECENT FINDINGS: The prevalence of urinary incontinence in women ranged from 5 to 69%, with most studies reporting a prevalence of any urinary incontinence in the range of 25-45%. In a longitudinal population study in which women were followed for 16 years, the overall prevalence of urinary incontinence increased from 15 to 28%, and the incidence rate of urinary incontinence was 21%, whereas the corresponding remission rate was 34%. Increasing evidence is now available regarding a genetic component in the cause of stress urinary incontinence. The reported prevalence of OAB in women varied between 7.7 and 31.3%, and in general, prevalence rates increased with age. In a longitudinal study, the prevalence of OAB, nocturia and daytime micturition frequency of eight or more times per day increased by 9, 20 and 3%, respectively, in a cohort of women followed from 1991 to 2007. The incidence of OAB was 20%, and the corresponding remission rate was 43%. SUMMARY: Urinary incontinence and OAB are highly prevalent conditions. The cost of illness for urinary incontinence and OAB is a substantial economic and human burden and is likely to increase further in the future, highlighting the need for effective forms of management. [References: 43]
Publication Type
Journal Article. Review.
<8>
Unique Identifier
19057216
Status
MEDLINE
Authors
Gravas S. Melekos MD.
Authors Full Name
Gravas, Stavros. Melekos, Michael D.
Institution
Department of Urology, University Hospital of Larissa, Larissa, Greece.
Title
Male lower urinary tract symptoms: how do symptoms guide our choice of treatment?. [Review] [32 refs]
Source
Current Opinion in Urology. 19(1):49-54, 2009 Jan.
Abstract
PURPOSE OF REVIEW: Lower urinary tract symptoms (LUTS) include voiding, storage, and postmicturition symptoms whereas in addition LUTS and sexual dysfunction are highly prevalent in aging men. The present article investigates how symptoms can guide our initial therapeutic approach to male LUTS and provides the recent data on the current treatment options. RECENT FINDINGS: Recent studies suggest that not all male LUTS are associated with prostate pathology and that bladder plays a role in the development of LUTS and especially in storage symptoms. In addition to the traditional drug classes including alpha-blockers and 5alpha-reductase inhibitors, there is an increasing flow of data on the use of anticholinergics and phosphodiesterase type 5 inhibitors. Available studies provide high-level evidence on the efficacy and safety of these medical treatments. The upcoming data are beginning to shape new strategies for the initial management of male LUTS. SUMMARY: Male LUTS have a complex nature and there is an overlap of storage and voiding symptoms. Weighing of storage versus voiding symptoms is a decisive factor for the selection of medical treatment. In addition, assessment of specific voiding and prostate parameters and the status of patient's sexual function may guide our choice. [References: 32]
Publication Type
Journal Article. Review.
<9>
Unique Identifier
19057212
Status
MEDLINE
Authors
Ilie CP. ChancellorMB.
Authors Full Name
Ilie, Cristian P. Chancellor, Michael B.
Institution
Central Clinical EmergencyMilitaryHospital, Urology Department, Bucharest, Romania.
Title
Perspective of Botox for treatment of male lower urinary tract symptoms. [Review] [52 refs]
Source
Current Opinion in Urology. 19(1):20-5, 2009 Jan.
Abstract
PURPOSE OF REVIEW: Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH) are frequently encountered in ageing men. The medical treatment for lower urinary tract symptoms/BPH is not totally effective or without side effects. The use of transurethral resection of the prostate, the 'gold standard' surgical intervention for BPH is progressively changing to minimally invasive surgical therapies. But none of them provided clear long-term results, with no complication. Thus, there has been much interest in the development of alternative treatments such as the injection of botulinum toxin type A (BTX-A) into the prostate. RECENT FINDINGS: There are two main factors that contribute to lower urinary tract symptoms in BPH: the excessive growth (static component) and increase in smooth muscle tone (dynamic component). BTX-A seems to be the first therapeutic agent to target both factors. Its use inhibits the autonomic efferent effects on prostate growth and contraction and also inhibits the abnormal afferent effects on prostate sensation. BTX-A injected into prostate appears to be well tolerated and effective. SUMMARY: Although the clinical series demonstrate efficacy of minimum 6 months, more studies are necessary in order to identify the mechanisms by which BTX-A affects the prostate, the ideal dose and the duration of effect. BTX-A use in prostate disease is currently 'off-label'. [References: 52]
Publication Type
Journal Article. Review.
<10>
Unique Identifier
19089674
Status
MEDLINE
Authors
Di Benedetto P. Delneri C. Biasutti E. Bragadin LM. Giorgini T.
Authors Full Name
Di Benedetto, Paolo. Delneri, Cristina. Biasutti, Emanuele. Bragadin, Luisa Monti. Giorgini, Tullio.
Institution
Title
Vesicourethral dysfunction in multiple sclerosis. Initial assessment based on lower urinary tract symptoms and their pathophysiology. [Review] [17 refs]
Source
Neurological Sciences. 29 Suppl 4:S348-51, 2008 Dec.
Abstract
The most common lower urinary tract symptoms (LUTS) in multiple sclerosis (MS) are irritative, obstructive or mixed (association of irritative and obstructive LUTS). Generally irritative LUTS are typical in patients with cortical, brainstem or mild spinal cord lesions; obstructive symptoms are frequent in patients with spinal cord lesions (below the pontine micturition centre) or at the level of the sacral micturition centre. Irritative LUTS are often associated with detrusor overactivity, whereas obstructive LUTS are associated with detrusor sphincter dyssynergia or detrusor areflexia/hypocontractility. Proper management of these LUTS often could be planned without specialised assessment, in accordance with the algorithms proposed by International Consultation on Incontinence. [References: 17]
Publication Type
Journal Article. Review.
<11>
Unique Identifier
19032606
Status
MEDLINE
Authors
Roehrborn CG.
Authors Full Name
Roehrborn, Claus G.
Institution
University of Texas Southwestern MedicalCenter, Department of Urology, Dallas, TX75390-9110, USA.
Title
Currently available treatment guidelines for men with lower urinary tract symptoms. [Review] [11 refs]
Source
BJU International. 102 Suppl 2:18-23, 2008 Nov.
Publication Type
Journal Article. Review.
<12>
Unique Identifier
19032605
Status
MEDLINE
Authors
Roehrborn CG.
Authors Full Name
Roehrborn, Claus G.
Institution
University of Texas Southwestern MedicalCenter, Department of Urology, Dallas, TX75390-9110, USA.
Title
Clinical management of lower urinary tract symptoms with combined medical therapy. [Review] [37 refs]
Source
BJU International. 102 Suppl 2:13-7, 2008 Nov.
Publication Type
Journal Article. Review.
<13>
Unique Identifier
18607596
Status
MEDLINE
Authors
Kedia GT. Uckert S. Jonas U. Kuczyk MA. Burchardt M.
Authors Full Name
Kedia, George T. Uckert, Stefan. Jonas, Udo. Kuczyk, Markus A. Burchardt, Martin.
Institution
Department of Urology, HannoverMedicalSchool, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Title
The nitric oxide pathway in the human prostate: clinical implications in men with lower urinary tract symptoms. [Review] [52 refs]
Source
World Journal of Urology. 26(6):603-9, 2008 Dec.
Abstract
To date, there is an increasing interest in the nitric oxide (NO) pathway as a potential pharmacological target to treat male lower urinary tract symptomatology (LUTS). In the transition zone of the human prostate, a dense nitrinergic innervation has been shown of the fibromuscular stroma, glandular epithelium and blood vessels. The expression of key proteins of the NO pathway, such as the endothelial and neuronal nitric oxide synthase (eNOS, nNOS), cGMP-degrading phosphodiesterase type 5 (PDE5) and cGMP-binding protein kinase (cGK), has also been demonstrated. The hypothesis that an impaired NO/cGMP-signaling may contribute to the pathophysiology of benign prostatic hyperplasia (BPH) is supported by the results from randomized, placebo-controlled clinical studies, indicating that NO donor drugs and PDE5-inhibitors sildenafil, tadalafil and vardenafil may be useful to treat storage and voiding dysfunctions resulting from LUTS in men. Thus, given a potential role of the NO-pathway in the prostate and/or in other parts of lower urinary tract (e.g. bladder), the enhancement of the NO signaling by NO donor drugs, PDE5 inhibitors or activators of the soluble guanylyl cyclase (sGC) may represent a new therapeutic strategy for the treatment of LUTS. This review serves to focus on the role of NO and the NO-dependent signaling in the control of smooth muscle function in the human prostate. Results from clinical trials in men with LUTS/BPH are also discussed. [References: 52]