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Evaluating the Impact of Digital Therapy for Male LUTS: Insights from the BEST Trial Subgroup Analysis - Beyond the Abstract

App-based therapy is no longer just a novel concept: It can meaningfully improve symptoms for men across the spectrum of lower urinary tract symptoms (LUTS).

The recent BEST trial subgroup analysis confirms that Kranus Lutera, a structured 12-week digital therapeutic, delivers clinically meaningful improvements regardless of age, diagnosis, baseline symptom severity, or concurrent medication. Men with severe LUTS and urge-predominant symptoms experienced the largest gains, highlighting the potential of conservative, app-based therapy even in patients often considered for pharmacologic or surgical treatment.

Key Observations Include:

  • Consistent efficacy across subgroups: Symptom relief and quality-of-life improvements were observed in patients with benign prostate hyperplasia (BPH) as well as in patients with Overactive Bladder (OAB), and mixed presentations, and across age groups, including those over 70.
  • Complementary to medication: Men receiving concurrent LUTS-specific therapy also benefited, while those not on medication achieved meaningful standalone improvements.
  • Behavioral impact confirmed: Micturition diary data showed reduced daytime and nighttime voiding and fewer urgency episodes, translating digital engagement into real-life symptom control.
  • High adherence and engagement: 84% of participants reported frequent app use, validated by backend data, demonstrating feasibility and patient integration into daily routines.
Digital therapeutics like Kranus Lutera may help bridge gaps in conservative LUTS management, overcoming barriers to traditional behavioral interventions such as time constraints and limited access to supervised programs, and with the benefit of having no side effects. By delivering guideline-based pelvic floor exercises, bladder training, bladder diaries, and education via an accessible digital interface, patients can actively engage in symptom management on their own terms anytime and anywhere.

Looking Ahead:

While longer-term data are needed to confirm sustainability, these findings support a versatile role for digital therapy in male LUTS: as a standalone option, an adjunct to pharmacologic therapy, or a scalable tool to implement guideline-based conservative management strategies more broadly.

Written by: Laura Wiemer, MD, Charité Universitätsmedizin Berlin, Berlin, Germany

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