Benign prostatic hyperplasia and lower urinary tract symptoms. A review of current evidence

CONTEXT - The treatment of benign prostatic hyperplasia (BPH) is changing due to a greater understanding of the disease and the development of the functional concept of lower urinary tract symptoms (LUTS).

OBJECTIVES - To describe the current state of BPH and the diagnosis and treatment of LUTS.

ACQUISITION OF EVIDENCE - We summarise the issues presented and debated by a group of expert urologists during the First UROVI Congress, sponsored by the Spanish Urological Association.

SUMMARY OF EVIDENCE - LUTS encompasses filling, voiding and postvoiding symptoms that affect patients' quality of life. The aetiological diagnosis is an important element in starting the most ideal treatment. For this reason, new alternative therapies (both pharmacological and surgical) are needed to help individually address the symptoms in the various patient profiles. There is now a new combination of drugs (6mg of solifenacin and 0. 4mg of the tamsulosin oral controlled absorption system) for treating moderate to severe filling symptoms and emptying symptoms associated with BPH in patients who do not respond to monotherapy. Furthermore, new surgical techniques that are increasingly less invasive help provide surgical options for older patients and those with high comorbidity.

CONCLUSIONS - The availability of drugs that can act on the various LUTS helps integrate the pathophysiological paradigm into the functional one, providing more appropriate treatment for our patients.

Actas urologicas espanolas. 2016 Jan 25 [Epub ahead of print]

V M Carrero-López, J M Cózar-Olmo, B Miñana-López

Servicio de Urología, Hospital Universitario Infanta Leonor, Madrid, España.  Servicio de Urología, Complejo Hospitalario Universitario de Granada, Granada, España. , Servicio de Urología, Hospital General Universitario Morales Meseguer, Murcia, España.