Management of overactive bladder and lower urinary tract symptoms in men

According to prevailing clinical wisdom, most male lower urinary tract symptoms have been ascribed to disorders of the bladder outlet and the prostate gland in particular. Therefore, most pharmacologic therapy and surgical therapy has been directed toward the prostate. However, emerging laboratory and clinical data suggest that the bladder may be an important factor in the genesis of male lower urinary tract symptomatology, often independent of bladder outlet disorders. Overactive bladder, a diagnosis given to women with urinary frequency, urgency, and nocturia, clearly also occurs in men. In this context, and with the proliferation of various terminology changes describing lower urinary tract function, it is increasingly important to use precise and correct terminology when referring to male voiding symptoms and their treatment. Further, the traditional application of pharmacologic therapy for male lower urinary tract symptoms (LUTS) is undergoing changes, with antimuscarinics being used in some men with LUTS either alone or in combination with other oral therapies such as α-blockers. The therapy for LUTS in men will continue to evolve as newer agents in various pharmacologic classes become available.