Prevalence of lower urinary tract symptoms among female elementary school teachers in Taipei

The aim of this study was to estimate the prevalence of lower urinary tract symptoms (LUTS) among female elementary school teachers in Taipei. A total of 520 self-administered surveys were distributed to 26 elementary schools in Taipei City. Data analyses were based on 445 usable surveys. The prevalence rates for different types of LUTS ranged from 9.9 to 44.5%. The prevalence of urinary incontinence (UI; 26.7%) and nocturia (16.0%) fell within the prevalence estimates of these LUTS in North American and European women. Employed women in this study were more likely to experience LUTS than women in previous epidemiological or community studies. This study extended research on UI into other LUTS among employed women in Asia. Study results suggest that the working environment may affect LUTS in female elementary school teachers. This preliminary study is important for developing future behavioral interventions for female LUTS in the workplace.     

Are oxidative stress and ischemia significant causes of bladder damage leading to lower urinary tract dysfunction? Report from the ICI-RS 2019

Several studies indicate that pelvic ischemia and oxidative stress may play a significant role in lower urinary tract dysfunction (LUTD), including detrusor overactivity (DO)/overactive bladder (OAB) and detrusor underactivity (DU)/underactive bladder (UAB). The present article addresses proposal 1: “Are oxidative stress and ischemia significant causes of bladder damage leading to LUTD?” from the 2019 International Consultation on Incontinence—Research Society (ICI-RS) meeting. Bladder ischemia in animals and humans is briefly described, along with the proposed progression from ischemia to LUTD. Bladder ischemia is compared with ischemia of other organs, and the ongoing development of pelvic ischemia animal models is discussed. In addition, the distribution of blood within the bladder during filling and voiding and the challenges of quantification of blood flow in vivo are described. Furthermore, oxidative stress, including potential biomarkers and treatments, and challenges regarding antioxidant therapy for the treatment of LUTD are discussed. Finally, seven critical research questions and proposed studies to answer those questions were identified as priorities that would lead to major advances in the understanding and treatment of lower urinary tract symptoms (LUTS)/LUTD associated with pelvic ischemia and oxidative stress.     

Core Lower Urinary Tract Symptom Score (CLSS) questionnaire: A reliable tool in the overall assessment of lower urinary tract symptoms

Objectives: To identify the symptoms of higher relevance in patients complaining of lower urinary tract symptoms (LUTS). Methods: A questionnaire covering 25 LUTS as defined by the International Continence Society (ICS) terminology committee was administered to 1000 adults complaining of LUTS and 360 not complaining (controls). Symptoms were defined as ‘highly relevant (core LUTS)’ when indicated by at least 25% of symptomatic patients with nine common diseases/conditions as one of the three symptoms that had a significant impact on their daily life. Results: Ten symptoms (daytime frequency, nocturia, urgency, urgency incontinence, stress incontinence, slow urinary stream, straining, feeling of incomplete emptying, bladder pain, and urethral pain) were selected as being of high relevance. Core LUTS all showed significantly higher scores in the symptomatic patients than in the controls and they were not correlated with other more prevalent symptoms. The Core LUTS score (CLSS) questionnaire derived from these 10 symptoms was confirmed as showing test‐retest reliability. Conclusions: Of 25 LUTS defined by the ICS committee, 10 symptoms were selected as core LUTS. The CLSS, a questionnaire for core LUTS, provides an overall assessment of relevant symptoms without significant omissions. It might be useful for new patients, those with multiple diseases, and those without a definite diagnosis, as well as before and after interventions that may cause other symptoms.     

Lower urinary tract symptoms in chronically constipated women

Introduction and hypothesis

The prevalence of lower urinary tract symptoms (LUTS) is as high as 66 % in the general population. Constipation rates of >30 % were reported among women with LUTS. We examined the association of chronic constipation to the occurrence of LUTS and, in particular, the relationship of LUTS to the type of constipation. We also examined the prevalence and association of pelvic organ prolapse (POP) to LUTS.

Methods

In a retrospective survey of data collected on patients referred to our clinic during 2008–2009 for assessment of chronic constipation, 161 constipated women and 162 healthy female volunteers completed a structured questionnaire of urinary and bowel habits components (BBUS-Q22), the constipation scoring system for assessment of constipation severity and the Rome III component for IBS and chronic constipation. The constipated group underwent dynamic transperineal ultrasound.

Results

Demographic data was similar in both groups. LUTS were more common in the constipated group (increased urinary frequency 34 % vs. 14 %, p?<?0.001, nocturia 31 % vs. 8 %, p?<?0.001, urinary urgency 53 % vs. 21 %, p?<?0.001, incomplete urinary emptying 24 % vs. 9 %, p?=?0.003 and urinary incontinence 21 % vs. 5 %, p?<?0.0001). Urinary symptoms did not vary between IBS and functional constipation. In addition, the occurrence of urinary symptoms was unrelated to the diagnosis of posterior pelvic organ prolapse (POP) in the constipated group.

Conclusions

LUTS are common in constipated women, but are unrelated to the type of constipation. These findings may suggest that the constipation process may have a direct contribution to the occurrence of LUTS.     

尿动力学检查在女性下尿路疾病中的应用（附78例报告）

目的：研究以下尿路症状为主诉的女性患者的尿动力学变化及其临床意义。方法：女性患者,年龄21～86岁,临床表现为储尿期和（或）排尿期症状,采用尿动力学方法检查尿流率,同步膀胱压力容积流率及肛门括约肌肌电图测定。结果：以排尿症状为主者64例,以储尿症状为主者12例,不稳定膀胱2例。下尿路梗阻28例,其中功能性逼尿肌外括约肌协同失调的16例;子宫阴道下垂伴下尿路梗阻21例;压力性尿失禁18例,其中Ⅰ型5例,Ⅱ型3例,Ⅲ型3例,Ⅱ／Ⅲ型7例。正常9例。结论：尿动力学检查能了解膀胱的功能状况,为临床治疗的选择提供了可靠的依据。     

逼尿肌活动低下在下尿路症状中的临床特征及诊疗策略分析

目的:探讨逼尿肌活动低下(DU)在下尿路症状(LUTS)患者中的流行病学现状、临床特征及诊疗策略。方法:回顾性分析了我院1 019例排除神经源性膀胱及解剖结构异常的LUTS患者的尿流动力学检查结果及随访资料,探讨DU在LUTS中的流行病学及临床诊治特点,并对106例DU患者治疗前后行尿流动力学检查,结合文献进行临床分析。结果:在就诊患者中,储尿期症状最为多见,在男性患者中,排尿期症状稍多于储尿期症状,而女性患者储尿期症状明显多于排尿期症状。男性患者中膀胱出口梗阻(BOO)的患者为57.9%,而女性患者中压力性尿失禁(SUI)患者达到了43.3%。27.4%男性及23.2%女性诊断为DU,男性及女性患病率差异无统计学意义。DU患者与非DU患者的临床表现无明显差异,均以LUTS为主要表现。DU可能合并有逼尿肌过度活动或BOO。DU随着年龄的增加,患病率逐渐增加。106例DU患者经治疗后行尿动力学检查发现逼尿肌收缩力有一定提高,治疗前后逼尿肌肌力差异有统计学意义。结论:DU是LUTS患者的常见病因,并有可能同时合并有逼尿肌过度活动或BOO。目前针对DU患者的治疗有一定效果。     

难治性男性下尿路症状的尿动力学分析

目的：研究难治性男性下尿路症状病因及尿动力学表现。方法：选择24例外院诊断为慢性前列腺炎经反复治疗效果不佳的患者行尿动力学检查。根据膀胱测压、压力-流率、盆底肌电图及尿道压进行诊断。结果：24例中完成检查22例,结果异常18例。顺应性下降并发逼尿肌过度活动1例,逼尿肌过度活动4例,膀胱感觉过敏2例,功能失调性排尿2例,膀胱出口梗阻6例,逼尿肌收缩力下降3例。结论：尿动力学对难治性男性下尿路症状的疾病诊断及治疗具有重要的指导意义。     

Abnormal pelvic response to cough in women with stress urinary incontinence

AIMS: To assess how muscular fatigue deteriorates the modulation of pelvic contraction during increasing cough efforts. Furthermore, we investigated the correlation between the temporal course of pelvic floor activation during cough. METHODS: Informed consent was obtained from 20 women presenting with SUI and 6 continent women (overactive bladder syndrome [OAB]). Bladder pressure (BP) and external anal sphincter electromyographic activity (EAS EMGi) were recorded concomitantly during increasing cough efforts. Modulation of pelvic contraction was assessed before and after two types of intense pelvic exercise (Exercise #1: 10 successive strong cough efforts; Exercise #2: 10 pelvic contractions followed by a maximal pelvic contraction) at 0, 200, and 400 ml of bladder filling. We have also recorded electromyographic activity of external intercostal (EIC) muscles. RESULTS: Whereas the Exercise 1 had no effect on modulation, the Exercise 2 altered significantly the modulation of pelvic contraction during increasing cough efforts (P = 0.043) only in women presenting with SUI. The bladder filling volume seems to not significantly modify this modulation (P = 0.12). Median latency between the onset of the EAS EMGi and the onset of the EIC EMGi was -470 and -60 msec in OAB group and in SUI group, respectively (P = 0.012). There was a good correlation between mean latency (default of EAS EMGi pre-activation) and an altered modulation of pelvic contraction during increasing cough efforts (P = 0.040). CONCLUSIONS: Some women with SUI exhibit an altered pattern of the PFM response during increasing coughing efforts. The lack of this modulation of PFM response to stress may be one of the pathophysiologic factors of SUI.     

Prevalence and risk factors of lower urinary tract symptoms in Fuzhou Chinese women

AIMS: To evaluate the prevalence and associated risk factors of lower urinary tract symptoms (LUTS). METHODS: We randomly sampled 6066 women (3.0% of registered female residents aged 20 years and older in Fuzhou) and mailed Bristol Female Lower Urinary Tract Symptoms questionnaire to women for self-completion. 4684 (77.2%) women with evaluable data were included in this study. RESULTS: The prevalence of LUTS, voiding symptoms, storage symptoms was 39.7%, 13.4%, 37.3%, respectively. Among voiding symptoms, the prevalence of hesitancy, slow stream, intermittence, straining, terminal dribble, splitting was 6.8%, 5.5%, 4.8%, 4.5%, 4.1%, 3.5%, respectively. Among storage symptoms, stress incontinence, urge incontinence, urgency, frequency, nocturia, enuresis was 16.6%, 10.0%, 10.2%, 16.4%, 9.9%, 3.9%, respectively. A multiple logistic regression analysis showed menopause, parity > 2, constipation, fetal birthweight, and episiotomy were common potential risk factors for LUTS, voiding and storage symptoms. Higher BMI increased the occurrence of LUTS and storage symptoms, while cesarean delivery and labor protected against the development of storage symptoms. CONCLUSIONS: The prevalence of LUTS in Chinese women is lower than that of most reports in Occidental women. The prevalence of LUTS increases with age.     

alpha-Blockers improve chronic ischaemia of the lower urinary tract in patients with lower urinary tract symptoms

OBJECTIVE

To investigate whether a mechanism of action of α‐blockers on lower urinary tract symptoms (LUTS) involves improved perfusion of the LUT.

PATIENTS, SUBJECTS AND METHODS

The accuracy of perfusion measurements using transrectal colour Doppler ultrasound (TRCDUS) and colour pixel density (CPD) was initially confirmed in a porcine model. Following this confirmation, measurements were taken from four healthy male volunteers and 19 patients with LUTS. The urinary bladder was filled slowly (50 mL/min) with 0.2 m KCl, which resembles the osmolarity of concentrated urine, and evaluated by cystometry. In parallel, TRCDUS and measurement of the CPD of the LUT were performed. The patients with LUTS were then treated with daily α‐blocker (0.4 mg tamsulosin) for 5 weeks and urodynamic variables as well as perfusion were evaluated again.

RESULTS

In the healthy men, perfusion of the LUT increased considerably (157%) during filling of the bladder to a mean (sd ) maximum cystometric capacity (C_max) of 481 (28.9) mL. All the patients with LUTS had a reduced mean C_max during filling with KCl at 322.4 (58.5) mL. The mean CPD in the urinary bladder and the prostate were only increased by 58.4% during filling with KCl. After α‐blocker therapy the mean C_max during filling with KCl rose to 382.5 (42.9) mL; furthermore, perfusion of the LUT measured by CPD was significantly increased (132.8%).

CONCLUSIONS

The present data strongly suggest that LUTS are associated with chronic ischaemia of the prostate and urinary bladder. α‐blockers increase perfusion in the LUT and C_max. These results might explain the therapeutic effects of α‐blockers on LUTS.     

Urinary tract infections and bladder dysfunction after renal transplantation in children

PURPOSE: Urinary tract infection remains a major cause of morbidity in pediatric renal transplant recipients. In otherwise healthy children bladder dysfunction increases the susceptibility to urinary tract infection. The aims of this study were to determine whether bladder dysfunction affects the incidence of urinary tract infection after renal transplantation, and to assess the impact of recurrent urinary tract infections on graft function. MATERIALS AND METHODS: We evaluated bladder function with a questionnaire, uroflowmetry and bladder ultrasound, and renal function with clearance of inulin or iohexol (glomerular filtration rate) in 68 recipients of renal transplants 5 to 20 years old, at 1 to 15 years after transplantation, with and without recurrent urinary tract infections. RESULTS: Bladder dysfunction was equally common in children with and without recurrent urinary tract infections (68% vs 74%, not significant). Therefore, it had no effect on the incidence of recurrent urinary tract infections. Graft function deteriorated at a faster rate in patients with recurrent urinary tract infections than in those without (mean glomerular filtration rate 45 vs 57 ml per minute per 1.73 m(2) at 4 years after transplantation, p=0.02). CONCLUSIONS: Bladder dysfunction did not predispose patients to recurrent urinary tract infections. Graft function declined with time in all patients but the rate of deterioration was faster in the group with recurrent urinary tract infections.     

Association of non-urological diseases with lower urinary tract symptoms.

OBJECTIVE: Clinical observations indicate that many non-urological diseases seem to be associated with lower urinary tract symptoms (LUTS). This has also been shown in studies usually concerning single diseases. This study investigated the impact of non-urological diseases on LUTS in the general population. MATERIAL AND METHODS: A questionnaire on LUTS and medical history was mailed to all 50-, 60- and 70 year-old men in Tampere and in 11 municipalities in the same county, in total 3143 subjects. Day-time frequency, nocturia, urge, urge incontinence, hesitancy and incomplete emptying were used to form an index for LUTS. The men were asked to report any disease that they had. The number of the following diseases reported by the participants was large enough for statistical analysis: lower back pain, hypertension, arthritis, heart disease, pulmonary disease, diabetes, constipation. stroke, transient ischaemic attack, cancer (other than prostate or bladder), neurological disease, inguinal hernia, rheumatoid arthritis and faecal incontinence. The association between LUTS and non-urological diseases was estimated by logistic regression as a prevalence odds ratio (OR) with 95% confidence intervals (CI). RESULTS: In the multivariate analysis a significant association was found between LUTS and the following diseases: faecal incontinence (OR 4.5, CI 2 .3-9.1), neurological disease (OR 2.4, CI 1.3-4.4), constipation (OR 2.3, CI 1.5-3.3) and arthritis (OR 1.5, CI 1.2-2.0). CONCLUSIONS: According to this population-based study LUTS is an important part of the symptomatology of faecal incontinence, neurological disease, constipation and arthritis. Thus, the patients with these diseases and presenting with LUTS require careful investigation, at least in the cases in which the primary therapy of LUTS has failed.     

Premenopausal women with recurrent urinary tract infections have lower quality of life

Objectives

To examine the impact on quality of life of recurrent acute uncomplicated urinary tract infection among premenopausal Singaporean women, and to determine the risk factors for lower quality of life among these patients.

Methods

A total of 85 patients with recurrent acute uncomplicated urinary tract infection who were referred to the Urology Department at the National University Hospital, Singapore, were prospectively recruited over a 3‐year period to complete the validated Short Form 36 Health Survey version 1. In addition, demographic and clinical details including symptomology and medical history were analyzed for factors impacting quality of life. Short Form 36 Health Survey version 1 results were compared with published population norms.

Results

After adjusting for age, gender and race, recurrent acute uncomplicated urinary tract infection patients had significantly lower quality of life on seven out of eight Short Form 36 Health Survey version 1 domains when compared with age‐, gender‐ and race‐adjusted population norms for Singapore. Among those with recurrent acute uncomplicated urinary tract infection, those who also reported caffeine consumption had significantly lower Short Form 36 Health Survey version 1 scores than those who did not. Those who reported chronic constipation also had consistently lower Short Form 36 Health Survey version 1 scores across all domains.

Conclusions

Recurrent acute uncomplicated urinary tract infection has a negative impact on the quality of life of premenopausal, otherwise healthy women. Recurrent acute uncomplicated urinary tract infection patients who also have chronic constipation or consume caffeine have lower quality of life than those who do not. More studies are required to understand the relationships between these common problems and risk factors.

     

Physical activity, benign prostatic hyperplasia, and lower urinary tract symptoms

BACKGROUND: While some studies have indicated that physical activity may protect against benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS), others have not. OBJECTIVE: To evaluate the association of physical activity with BPH and LUTS. DESIGN, SETTING, AND PARTICIPANTS: Systematic review and meta-analysis using MEDLINE, the Cochrane Library, EMBASE, and abstracts from the Annual Meeting of the American Urological Association. We selected observational studies that provided empirical data and analyzed abstracted data with random effects models. MEASUREMENTS: BPH, LUTS, and physical activity levels. RESULTS AND LIMITATIONS: Eleven (n=43 083 men) studies met selection criteria. Eight studies observed inverse, 2 studies null, and 1 study equivocal associations of physical activity with BPH or LUTS. Eight studies (n=35675) were eligible for pooled analyses. We stratified physical activity levels into light, moderate, and vigorous categories, with a sedentary category for reference. Compared to the sedentary group, the pooled odds ratios for BPH or LUTS were 0.70 (95% CI 0.44-1.13, p=0.14), 0.74 (95% CI 0.60-0.92, p=0.005), and 0.74 (95% CI 0.59-0.92, p=0.006) for men engaging in light, moderate, and heavy physical activity, respectively. CONCLUSIONS: Physical activity reduces the risks of BPH and LUTS. These findings are consistent with other studies demonstrating that the BPH/LUTS complex is associated with modifiable risk factors of cardiovascular disease and suggest that increased physical activity may prevent or attenuate these conditions.     

The rationale for bladder washouts in children with neurogenic bladder

Children with a neurogenic bladder are at risk of developing recurrent urinary tract infections and long-term kidney failure. Due to an altered lower urinary tract, children may be overtreated for simple bacteriuria or undertreated for a potentially severe urinary tract infection. This group of patients represent high users of healthcare, and are at risk of colonization and development of antibiotic resistance. Bladder washouts with non-antibiotic electrochemically activated solutions are a potential new prophylactic option for patients with bladder dysfunction when clean intermittent catheterization has resulted in chronic bacteriuria.     

Monitoring urinary bladder volume and detecting post-operative urinary retention in children with an ultrasound scanner

BACKGROUND: Post-operative urinary retention (PUR) is associated with a risk of over-distension and permanent detrusor damage. The prevention of PUR by routine catheterization may increase the risk of urinary tract infection. Post-operative monitoring of the bladder volume is a reliable method in adults, but has not been evaluated for reliability in children. METHODS: Forty-eight patients who, according to current clinical guidelines, required urinary bladder emptying were scanned before catheterization using the Bladderscan. Volumes estimated with ultrasound were compared with volumes measured after emptying the bladder with a catheter. Bladder emptying was controlled by concomitant fluoroscopy in 20 children. RESULTS: The mean difference between the ultrasound estimates and the catheter-emptied urine volumes was 4 ml [standard deviation (SD) = 25 ml] in 26 children above the age of 3 years and -18 ml (SD = 19 ml) in 22 younger children. In the subpopulation in whom complete bladder emptying could be confirmed by fluoroscopy (14 children; median age, 3 years; range, 1-11 years), the mean difference between the ultrasound estimates and the catheter-emptied volumes was -11 ml (SD = 24 ml). CONCLUSIONS: This study confirms agreement between the ultrasound scanner estimates of urinary bladder volume and the urine volume measured by emptying the bladder. Reliability was good in children above the age of 3 years. The volume was underestimated in younger children. Thus, routine monitoring of urinary bladder volume with an ultrasound scanner is a non-invasive, pain-free and reliable way of preventing over-distension of the urinary bladder in children after surgery and other procedures under general anaesthesia.     

A型肉毒毒素治疗神经源性尿潴留21例临床观察

目的：观察A型肉毒毒素治疗神经源性尿潴留的疗效,不良反应和有效时间。方法：收集21例神经疾病后尿潴留患者,A型肉毒毒素尿道外括约肌注射,记录治疗前后症状,尿流动力学指标,综合评估A型肉毒毒素治疗神经源性尿潴留的疗效,并记录不良反应和有效时间。结果：A型肉毒毒素治疗神经源性尿潴留,患者症状可明显改善,生存质量评分和国际下尿路综合征症状评分明显改善,尿流动力学指标明显改善,未见明显不良反应,疗效可维持（34-1）（1～5）个月。结论：A型肉毒毒素尿道外括约肌注射是一种治疗神经源性尿潴留的有效方法,短期内对部分患者能够显著改善排尿症状,提高生存质量,且未见不良反应。     

Lifestyle and behavioural interventions for men on watchful waiting with uncomplicated lower urinary tract symptoms: a national multidisciplinary survey

OBJECTIVE: To determine the use of lifestyle and behavioural interventions in the UK for symptom control in men with uncomplicated lower urinary tract symptoms (LUTS) on watchful waiting (WW). METHOD: Semi-structured interviews with urologists, nurse practitioners and continence advisors were used to obtain a list of lifestyle and behavioural interventions used in men with LUTS. From the 18 interventions identified, a survey was constructed asking how often these interventions were used in routine practice. The survey was sent to 100 consultant urologists (British Association of Urological Surgeons), 100 nurse practitioners (British Association of Urological Nurses), and 100 continence advisors (International Continence Society) with an interest in male urology, all randomly selected. RESULTS: Of 248 (83%) responses, 236 were suitable for analysis; 193 (82%) of the respondents reported using lifestyle or behavioural interventions in men on WW with uncomplicated LUTS. The most frequently used interventions were education about the prostate and bladder, avoiding caffeine, urethral milking and reassuring men that they do not have prostate cancer. The use of lifestyle and behavioural interventions showed an 'all-or-none' pattern. Respondents used either few or many of the 18 interventions identified. There was considerable variation in the extent to which these interventions were used among the survey groups (P < 0.01); urologists used these interventions the least and continence advisors the most. CONCLUSIONS: Lifestyle and behavioural interventions are advised by many medical professionals to men on WW with uncomplicated LUTS. However, the use varies considerably, with some medical professionals advising many of these interventions and some a few or none at all. Further research is required to define and test the effectiveness of these interventions in reducing LUTS.     

Pathophysiology and subjective symptoms in women with impaired bladder emptying

AIM: To assess the pathophysiology and subjective symptoms in female patients with impaired bladder emptying. METHODS: Eighty-three consecutive female patients attending a urology clinic with postvoid residual urine of more than 100 mL were recruited. Free uroflowmetry, measurement of postvoid residual urine and pressure-flow study were performed in all patients. The detailed assessment of subjective symptoms and their bothersomeness to the patients were assessed using a self-administered questionnaire comprising 12 items: five associated with voiding symptoms, five with storage symptoms, and two with discomfort and pain on voiding. The questionnaire was applied to 83 patients with impaired bladder emptying, 41 patients with urinary incontinence, and 21 normal controls. RESULTS: Although 77% of the patients with impaired bladder emptying consulted a urology clinic because of voiding symptoms, the remaining 23% complained of storage symptoms or symptoms other than lower urinary tract symptoms (LUTS). The pressure-flow study revealed the pathophysiology of impaired bladder emptying as impaired detrusor contraction in 68 patients (81.9%), and bladder outlet obstruction in 12 patients (14.8%). The assessment of subjective symptoms using the questionnaire revealed that the patients with urinary incontinence showed a high frequency only in storage symptoms; however, those with impaired bladder emptying revealed a high frequency not only in voiding but also in storage symptoms. CONCLUSIONS: Female patients with impaired bladder emptying present with a wide range of lower urinary tract symptoms associated with both voiding and storage symptoms. To determine an appropriate treatment modality, the correct diagnosis of the underlying pathophysiology of impaired bladder emptying by pressure-flow study is of primary importance.     

Clinical guidelines for male lower urinary tract symptoms associated with non-neurogenic overactive bladder

The purpose of this guideline is to direct urologists and patients regarding how to identify overactive bladder (OAB) in male patients with lower urinary tract symptoms (LUTS) and to make an accurate diagnosis and establish treatment goals to improve the patients' quality of life (QoL). LUTS are commonly divided into storage, voiding, and postmicturition symptoms, and are highly prevalent in elderly men. LUTS can result from a complex interplay of pathophysiologic features that can include bladder dysfunction and bladder outlet dysfunction such as benign prostatic obstruction (BPO) or poor relaxation of the urethral sphincter. Diagnosis of OAB in male LUTS leads to accurate diagnosis of pure OAB and bladder outlet-related OAB, and appropriate treatment in men with residual storage symptoms after treatment for LUTS.