BMJ  2007;334:2 (6 January), doi:10.1136/bmj.39063.645532.BE

Editorials

Lower urinary tract symptoms in men

Self management is at least as effective as watchful waiting, and may delay further intervention

The first 150 words of the full text of this article appear below.

Lower urinary tract symptoms—including voiding, storage, and postvoiding symptoms—occur in half of men over 65 and adversely affect quality of life and activities of daily living.1 2 Treatment varies from watchful waiting (active surveillance and monitoring) to medical and surgical management. While absolute indications for surgery exist—including persistent retention, severe symptoms, and secondary renal impairment—recent experience in clinical practice suggests that most patients do not need surgery in the long term and can be managed by conservative measures.3 In this week's BMJ, Brown and colleagues report the first randomised controlled trial on the effect of self management training as a first line treatment in men with lower urinary tract symptoms.4

Symptoms associated with bladder outlet obstruction due to histological benign prostatic hyperplasia vary in nature and severity. Currently, about a third of patients in the United Kingdom are managed with watchful waiting.5 Figures are probably similar internationally as this management . . . [Full text of this article]

Christopher R Chapple, professor of urology and consultant urological surgeon , Anand K Patel, urology research fellow

1 Royal Hallamshire Hospital, Sheffield S10 2JF

c.r.chapple@sheffield.ac.uk


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Relevant Article

Self management for men with lower urinary tract symptoms: randomised controlled trial
Christian T Brown, Tet Yap, David A Cromwell, Lorna Rixon, Liz Steed, Kathleen Mulligan, Anthony Mundy, Stanton P Newman, Jan van der Meulen, and Mark Emberton
BMJ 2007 334: 25. [Abstract] [Full Text] [PDF]

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