Overactive bladder in men: special considerations for evaluation and management

• Published in: Urology (Ridgewood, N.J.) N.J.), 2002-11, Vol.60 (5), p.56-62
• Main Authors: Dmochowski, Roger R, Staskin, David
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Humans; Male; Middle Aged; Prostatectomy; Prostatic Hyperplasia - complications; Prostatic Hyperplasia - diagnosis; Prostatic Hyperplasia - surgery; Quality of Life; Severity of Illness Index; Sex Factors; Urinary Bladder Diseases - diagnosis; Urinary Bladder Diseases - therapy; Urinary Bladder Neck Obstruction - complications; Urinary Bladder Neck Obstruction - diagnosis; Urinary Bladder Neck Obstruction - surgery; Urinary Bladder, Neurogenic - complications; Urinary Bladder, Neurogenic - diagnosis; Urination Disorders - diagnosis; Urination Disorders - etiology; Urination Disorders - therapy; Urodynamics
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/S0090-4295(02)01797-1

Lower urinary tract symptoms (LUTS) in men may arise from a variety of underlying causes, including benign prostatic hyperplasia. LUTS may have a significant component of storage symptoms (urgency, frequency, urge incontinence) at presentation; however, the absence of overactive bladder (OAB) symptoms does not necessarily imply pure outlet obstruction nor does their presence indicate the lack thereof. Symptomatic correlates to urodynamic findings are high when considering isolated OAB symptoms. However, mixed presentations or more overtly obstructive scenarios have less correlation with baseline symptom appraisal instruments. The ideal approach for diagnosis and management is predicated on a graded approach, with more invasive evaluation withheld for those men in whom presumptive therapy fails or who present with associated complex symptoms and in whom a higher level of intervention is being considered. The increasing incidence of LUTS with age implies a partial detrusor contribution, which must be considered in the overall management schema.