12th CEM: key messages in the treatment of LUTS

Prostate conditions such as benign prostate obstruction (BPO) and Lower Urinary Tract Symptoms (LUTS) were taken up in the first plenary session of the EAU 12th Central European Meeting which opened today in Dresden, Germany. Miroslav Zolesky (Prague, CZ) spoke on the challenge of persistent LUTS despite ‘successful’ surgery. In describing the pathophysiology of LUTS, Zolesky described the distinctions between voiding and storage symptoms. He also noted that post-evacuating symptoms in affected patients often include a feeling of incomplete emptying and post-micturation dribble.

He then stressed the role and importance of conducting a comprehensive urodynamic assessment that can offer insights or enable the effective implementation of effective treatment. Among his key messages are:

• Permanent incontinence is relatively rare but serious complication of BPH surgery (occurs);
• Persisting voiding symptoms could be caused by persistent obstruction or detrusor under activity (DU);
• Complete urodynamic assessment in patients with persistent or recurrent LUTS following TURP is recommended to guide appropriate therapy;
• Persistent symptoms after ‘successful’ surgery are often storage symptoms caused by detrusor overactivity (DO);
• Symptoms of OAB do not improve after surgery for BPO at least in 1/3 of cases; and
• Patients should be informed about the failure rate of surgery and the persistence rate of OAB symptoms.