If LUTS is caused by BPH, patients should be informed about the lack of evidence for the hypothesis that LUTS can be cured and the increased potential risk of prostate cancer if the diagnosis of LUTS is made before prostate cancer is detected.
LUTS are very common, with a frequency comparable to the general population. LUTS are associated with a lower quality of life in men. The most important LUTS are urgency, nocturia and incontinence related to all components of the IPSS.
There are about 1.28 million American persons who have LUTS with the greatest burden on their lives occurring in those with mild LUTS and moderate to severe LUTS.
About one-third of men presenting with lower urinary tract symptoms could have urological treatment for a non-urinary cause. The most common treatments were medications, such as alpha-blockers. Many of these medications could worsen or lessen the men’s symptoms.
Female and male patients with LUTS exhibit different lifestyles. LUTS also differs depending on the patients' age; LUTS increases across all age groups until middle age, but men and women over the age of 70 report LUTS at higher rates than younger men and women.
Patients with lower urinary tract symptoms often present with other symptoms, which may be underestimated. It is vital that gynaecologists take these into account when performing transvaginal pelvic examination in these patients.
Symptoms associated with lower urinary tract infection occur as common as urinary incontinence and occur more often when they are of moderate to severe intensity. Patients' attitudes towards lower urinary tract symptoms are a poor predictor of their impact as they do not necessarily recognize their impact on their daily functioning.
The diagnosis and treatment of lower urinary tract diseases does not improve after the introduction of new treatment modalities. Although treatment guidelines are usually considered, these are only published for select patients, not for the general population.
Finasteride has no effect on urinary symptoms. Finasteride may be useful for reducing the recurrence of prostate cancer when combined with androgen deprivation therapy. Patients may experience reduced urinary symptoms such as urgency and the urge/toilet incontinence without an increase of serious urinary side effects with finasteride.
Finasteride is a drug with multiple uses. On the one hand, it is marketed for its treatment of benign prostatic hyperplasia (BPH). BPH is characterized by a noncancerous growth of the prostate gland that causes urinary frequency, feeling of incomplete emptying, difficulty urinating, or an inability to get rid of urine, or to empty the bladder completely in a consistent way. On the other hand, finasteride is marketed for the treatment of adult male pattern hair loss. Hair will begin to thin as a result of androgens. The connection between hair shedding and men, especially baldness, has been well documented for thousands and millennia.
There is a strong association between age at baseline and subsequent risk of developing LUTS and BOO. As such, it appears that most people who develop LUTS suffer from symptoms earlier in their lives. This research can be used to help patients and their families to better manage their voiding dysfunction.
[Finasteride 20 mg once daily had no significant effect on the frequency of adverse effects in a study of people with lower urinary tract symptoms. A greater number of people treated with finasteride 20 mg reported experiencing a greater number of adverse effects than placebo-treated men (6.3% vs, 4.1%) or women (9.1% vs, 5.7%), and these effects were related to higher doses of finasteride used for men (finasteride 2.0 mg versus finasteride 20 mg for men, and finasteride 20 mg versus finasteride 2.0 mg for women (p<0.0001; relative dose ratios 10).