1. INTRODUCTION
1.1. Aim and objectives
Lower urinary tract symptoms (LUTS) are common complaints in adult men that have a major impact on quality of life (QoL) and present a substantial economic burden. The present Guidelines focus on offering practical, evidence-based guidance on the assessment and treatment of men with various non-neurogenic, benign forms of LUTS. The understanding of the lower urinary tract (LUT) as a functional unit and the multifactorial aetiology of associated symptoms means that LUTS now constitute the main focus rather than the former emphasis on benign prostatic hyperplasia (BPH).
The term BPH (which is a histological diagnosis) is considered inappropriate because it is benign prostatic obstruction (BPO, a urodynamic diagnosis) that is treated if it is a cause of a man’s LUTS. It must be emphasised that clinical guidelines present the best evidence available to the experts. However, following guideline recommendations will not necessarily result in the best outcome. Guidelines can never replace clinical expertise when making treatment decisions for individual patients but rather help to focus decisions. Taking personal values and preferences/individual circumstances of patients into account is also important. Guidelines are not mandates and do not purport to be a legal standard of care.
1.2. Panel composition
The European Association of Urology (EAU) Non-neurogenic Male LUTS (MLUTS) Guidelines Panel consists of an international group of experts with urological and clinical epidemiological backgrounds. All experts involved in the production of this document have submitted potential conflict of interest statements which can be viewed on the EAU website Uroweb: https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts/.
1.3. Available publications
A quick reference document, the Pocket Guidelines, is available in print and on the Uroweb website. These are abridged versions, which may require consultation together with the full text version. All documents are accessible through the EAU website Uroweb: https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts.
1.4. Publication history
The Non-neurogenic MLUTS Guidelines were first published in 2000. All sections of the 2026 MLUTS Guidelines have been fully updated following a full literature search.
1.4.1. Summary of changes
All Chapters of the 2026 MLUTS Guidelines have been updated based on the 2024 version of the Guidelines. References have been added throughout the document and text updated accordingly. Other key changes incorporated in this publication include:
- Minor updates throughout Chapter 4 on diagnostic evaluation, including a new Section 4.15 discussing prostate cancer (PCa).
- Updates to the text in Section 5.1 on conservative treatment, including an update on the strength rating for β3 agonists.
- Addition and deletion of subsections in Section 5.3 on the surgical treatment of BPO, with special attention to alternative enucleation techniques and alternative ablative techniques, as well as new Sections 5.3.5.c.2 and 5.3.5.c.3.
- Addition of recommendations for management of male urinary incontinence (UI), both for diagnosis and conservative treatment.
- New Figure 7 on the management of detrusor underactivity (DU).
- New Section 5.8 on voiding dysfunction in young men.