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Personalized care for male LUTS: have we attained the holy grail?

Personalized decision-making is the ultimate goal of managing men with lower urinary tract symptoms caused by benign prostatic obstruction. Urodynamics can provide valuable information in these patients and a recent multicentre randomized trial has highlighted important findings warranting consideration, as well as indicating that further insights are needed.

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References

  1. Coyne, K. S. et al. The burden of lower urinary tract symptoms: evaluating the effect of LUTS on health-related quality of life, anxiety and depression: EpiLUTS. BJU Int. 103 (Suppl. 3), 4–11 (2009).

    Article  PubMed  Google Scholar 

  2. Gravas, S. et al. Management of non-neurogenic male LUTS. EAU https://uroweb.org/guideline/treatment-of-non-neurogenic-male-luts/ (2020).

  3. Jeong, S. J. et al. Prevalence and clinical features of detrusor underactivity among elderly with lower urinary tract symptoms: a comparison between men and women. Korean J. Urol. 53, 342–348 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  4. Neal, D. E. et al. Outcome of elective prostatectomy. BMJ 299, 762–767 (1989).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Thomas, A. W., Cannon, A., Bartlett, E., Ellis-Jones, J. & Abrams, P. The natural history of lower urinary tract dysfunction in men: the influence of detrusor underactivity on the outcome after transurethral resection of the prostate with a minimum 10-year urodynamic follow-up. BJU Int. 93, 745–750 (2004).

    Article  CAS  PubMed  Google Scholar 

  6. Drake, M. J. et al. Diagnostic assessment of lower urinary tract symptoms in men considering prostate surgery: a noninferiority randomised controlled trial of urodynamics in 26 hospitals. Eur. Urol. https://doi.org/10.1016/j.eururo.2020.06.004 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  7. Strand, D. W., Costa, D. N., Francis, F., Ricke, W. A. & Roehrborn, C. G. Targeting phenotypic heterogeneity in benign prostatic hyperplasia. Differentiation 96, 49–61 (2017).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Selman, L. E., Ochieng, C. A., Lewis, A. L., Drake, M. J. & Horwood, J. Recommendations for conducting invasive urodynamics for men with lower urinary tract symptoms: qualitative interview findings from a large randomized controlled trial (UPSTREAM). Neurourol. Urodyn. 38, 320–329 (2019).

    Article  PubMed  Google Scholar 

  9. Lewis, A. L. et al. Clinical and patient-reported outcome measures in men referred for consideration of surgery to treat lower urinary tract symptoms: baseline results and diagnostic findings of the Urodynamics for Prostate Surgery Trial; Randomised Evaluation of Assessment Methods (UPSTREAM). Eur. Urol. Focus 5, 340–350 (2019).

    Article  PubMed  Google Scholar 

  10. Aiello, M. et al. Quality control of uroflowmetry and urodynamic data from two large multicenter studies of male lower urinary tract symptoms. Neurourol. Urodyn. 39, 1170–1177 (2020).

    Article  PubMed  Google Scholar 

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Correspondence to Sachin Malde.

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E.S. has received consultancy fees from Laborie. S.M. declares no competing interests.

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Malde, S., Solomon, E. Personalized care for male LUTS: have we attained the holy grail?. Nat Rev Urol 17, 607–608 (2020). https://doi.org/10.1038/s41585-020-0371-3

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