Clinical guidelines for male lower urinary tract symptoms and benign prostatic hyperplasia

  • Yukio Homma
    Department of Urology Graduate School of Medicine The University of Tokyo Tokyo Japan
  • Momokazu Gotoh
    Department of Urology Nagoya University Graduate School of Medicine Nagoya Japan
  • Akihiro Kawauchi
    Department of Urology Shiga Medical University Shiga Japan
  • Yoshiyuki Kojima
    Department of Urology Fukushima Prefectural University of Medicine Fukushima Japan
  • Naoya Masumori
    Department of Urology Sapporo Medical University School of Medicine Sapporo Japan
  • Atsushi Nagai
    Department of Urology Kawasaki Medical School Kurashiki Japan
  • Tadanori Saitoh
    Department of Urology Sanikukai Hospital Tokyo Japan
  • Hideki Sakai
    Department of Urology Nagasaki University Nagasaki Japan
  • Satoru Takahashi
    Department of Urology Nihon University Tokyo Japan
  • Osamu Ukimura
    Department of Urology Kyoto Prefectural University of Medicine Kyoto Japan
  • Tomonori Yamanishi
    Department of Urology Dokkyo Medical University Tochigi Japan
  • Osamu Yokoyama
    Department of Urology University of Fukui Fukui Japan
  • Masaki Yoshida
    Department of Urology National Center of Geriatrics and Gerontology Obu Japan
  • Kenji Maeda
    Department of Urology Maeda Clinic of Internal Medicine Ageo Japan

Abstract

<jats:title>Abstract</jats:title><jats:p>The present article is the abbreviated English translation of the Japanese guidelines for male lower urinary tract symptoms and benign prostatic hyperplasia updated as of the end of 2016. The target patients are men aged >50 years complaining of lower urinary tract symptoms, with or without benign prostatic hyperplasia, and the target readers are non‐urological general physicians and urologists. Mandatory assessment for general physicians is medical history, physical examination, urinalysis and measurement of serum prostate‐specific antigen. Additional mandatory assessment for urologists is symptoms and quality of life assessment by questionnaires, uroflowmetry, residual urine measurement, and prostate ultrasonography. Nocturia requires special attention, as it can result from nocturnal polyuria and/or sleep disturbance rather than lower urinary tract disorders. Functional <jats:styled-content style="fixed-case">lower urinary tract disorders</jats:styled-content> with or without <jats:styled-content style="fixed-case">benign prostatic hyperplasia</jats:styled-content> are primarily managed by conservative therapy and medications, such as α<jats:sub>1</jats:sub>‐blockers and phosphodiesterase‐type 5 inhibitors. Use of other medications or combination pharmacotherapy is to be reserved for urologists. 5α‐Reductase inhibitors and anticholinergics or β3 agonists are indicated for men with enlarged prostates and overactive bladder symptoms, respectively. Surgical intervention for bladder outlet obstruction is considered for persistent symptoms or <jats:styled-content style="fixed-case">benign prostatic hyperplasia</jats:styled-content>‐related comorbidities. Surgical modalities should be optimized by the patient's characteristics, performance of equipment and the surgeon's experience.</jats:p>

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