Subject(s)
Lower Urinary Tract Symptoms/classification , Circadian Rhythm , Diurnal Enuresis/epidemiology , Diurnal Enuresis/physiopathology , Humans , Lower Urinary Tract Symptoms/epidemiology , Lower Urinary Tract Symptoms/physiopathology , Male , Middle Aged , Nocturia/epidemiology , Nocturia/physiopathology , Polyuria/epidemiology , Polyuria/physiopathology , Population Dynamics , Symptom Assessment , Urinary Bladder/innervationABSTRACT
Prostate cancer (PC) is the most common malignancy in men in the developed world and the second leading cause of cancer death in men in the USA, behind lung cancer. In Europe, it is the third leading cause of cancer death in men (after lung and colorectal cancers). The role of PC screening is currently being questioned. The following article summarises the most relevant epidemiological aspects of PC, as well as major clinical trials of PC screening, and recommendations of the various medical scientific associations on whether or not to screen for PC.
Subject(s)
Early Detection of Cancer/methods , Mass Screening/methods , Prostatic Neoplasms/diagnosis , Humans , Male , Prostatic Neoplasms/epidemiology , Prostatic Neoplasms/prevention & controlSubject(s)
Lower Urinary Tract Symptoms/drug therapy , Administration, Oral , Aged , Humans , Time FactorsABSTRACT
The relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) is the result of their greater association in advanced age. Nevertheless, several investigations show that urinary tract symptoms have an independent relationship with sexual dysfunction and lower satisfaction. Likewise, the severity of LUTS correlates with the magnitude of sexual dysfunction, which suggests a possible causal relationship. The combined therapeutic approach of these 2 entities (ED and LUTS) brings a benefit to the patient both in urinary symptoms and sexual sphere. This review focuses on the relationship between ED, LUTS due to benign prostatic hyperplasia, and related therapies.
Subject(s)
Erectile Dysfunction/etiology , Lower Urinary Tract Symptoms/etiology , Prostatic Hyperplasia/complications , Erectile Dysfunction/therapy , Humans , Lower Urinary Tract Symptoms/therapy , Male , Prostatic Hyperplasia/therapyABSTRACT
Lower urinary tract symptoms (LUTS) are a frequent cause of consultation in Primary Care, especially in men >40 years of age. Benign prostatic hyperplasia (BPH) has been recognized as the most common cause of bothersome LUTS, causing significant interference with everyday activities and quality of life. The purpose of this study is to provide an update on recent developments regarding the medical management of male LUTS.
Subject(s)
Lower Urinary Tract Symptoms/therapy , Prostatic Hyperplasia/complications , Quality of Life , Adult , Humans , Lower Urinary Tract Symptoms/epidemiology , Lower Urinary Tract Symptoms/etiology , MaleABSTRACT
Benign prostate hyperplasia (BPH) is a high-incidence condition. Its diagnosis and treatment is shared between urologists and Primary Care physicians. Its management uses up a significant amount of resources. The Spanish Society of Primary Care Physicians (SEMERGEN), the Spanish Society of General Practitioners and Family Doctors (SEMG), the Spanish Society of Family and Community Medicine (semFYC), and the Spanish Association of Urology (AEU) have prepared a document on the management and monitoring of BPH, in which the aim is to incorporate the latest evidence in order to update the previously published guidelines, and present them here in condensed form. The main objective of these new recommendations is to raise the awareness of Primary Care physicians and assist them in its diagnostic evaluation, treatment and monitoring, as well as providing unified consensus criteria for referral to the secondary care level.
Subject(s)
Lower Urinary Tract Symptoms/therapy , Practice Guidelines as Topic , Prostatic Hyperplasia/therapy , Consensus , Humans , Lower Urinary Tract Symptoms/etiology , Male , Primary Health Care , Prostatic Hyperplasia/complications , Prostatic Hyperplasia/diagnosis , Referral and Consultation , SpainABSTRACT
Despite the high incidence of urinary incontinence (UI), health professional awareness of this disease is low, which in itself is not serious but significantly limits the lives of the patients. The Primary Care associations, Sociedad Española de Médicos de Atención Primaria [SEMERGEN], Sociedad Española de Médicos Generales y de Familia [SEMG], Sociedad Española de Medicina de Familia y Comunitaria [semFYC]) along with the Asociación Española de Urología (EAU) have developed this consensus with the proposal of making GPs aware, and to help them in the diagnosis, treatment and referral to Urologists. The first goal in primary care must be the detection of UI, thus an opportunistic screening at least once in the lifetime of asymptomatic women > 40 years old and asymptomatic men > 55 years old. The diagnosis, based on medical history and physical examination, must determine the type and severity of the UI in order to refer severe cases to the Urologist. Except for overactive bladder (OAB), non-pharmacological conservative treatment is the first approach to uncomplicated UI in females and males. Antimuscarinics are the only drugs that have demonstrated efficacy and safety in urge urinary incontinence (UUI) and OAB. In men with mixed symptoms, excluding severe obstruction cases, a combination therapy of alpha-blockers and antimuscarinics should be chosen.
Subject(s)
Urinary Incontinence/diagnosis , Urinary Incontinence/therapy , Adult , Algorithms , Female , Humans , Male , Middle Aged , Primary Health Care , Referral and Consultation , Surveys and QuestionnairesABSTRACT
A pesar de la elevada incidencia de incontinencia urinaria (IU) existe una escasa sensibilización de los profesionales sanitarios hacia esta afección, que no es grave, pero que sí autolimita de forma importante la vida de las personas que la presentan. Las sociedades científicas de Atención Primaria (Sociedad Española de Médicos de Atención Primaria [SEMERGEN], Sociedad Española de Médicos Generales y de Familia [SEMG], Sociedad Española de Medicina de Familia y Comunitaria [semFYC]) y la Asociación Española de Urología [AEU]) han elaborado este documento de consenso con los objetivos de sensibilizar al médico de atención primaria y ayudarle a la evaluación diagnóstica, tratamiento y derivación al especialista de la IU. El primer objetivo desde atención primaria (AP) debe ser la detección de la IU, por lo que se recomienda realizar un cribado oportunista al menos, una vez a lo largo de la vida en mujeres asintomáticas > 40 años y en varones asintomáticos > 55 años. En la evaluación diagnóstica, basada en la anamnesis y la exploración física, se deberá determinar el tipo y gravedad de la IU con el objetivo de derivar al especialista los casos de IU complicada. Con excepción de la vejiga hiperactiva (VH), el tratamiento conservador no farmacológico constituye el abordaje principal de la IU no complicada, tanto en mujeres como en varones. En la IU de urgencia/VH (IUU/VH), los antimuscarínicos son los únicos fármacos que han demostrado eficacia y seguridad. En el caso de los varones con síntomas mixtos, excluyendo los casos de obstrucción severa, se debe optar por un tratamiento combinado de alfa-bloqueantes y antimuscarínicos (AU)
Despite the high incidence of urinary incontinence (UI), health professional awareness of this disease is low, which in itself is not serious but significantly limits the lives of the patients. The Primary Care associations, Sociedad Española de Médicos de Atención Primaria [SEMERGEN], Sociedad Española de Médicos Generales y de Familia [SEMG], Sociedad Española de Medicina de Familia y Comunitaria [semFYC]) along with the Asociación Española de Urología (EAU) have developed this consensus with the proposal of making GPs aware, and to help them in the diagnosis, treatment and referral to Urologists. The first goal in primary care must be the detection of UI, thus an opportunistic screening at least once in the lifetime of asymptomatic women > 40 years old and asymptomatic men > 55 years old. The diagnosis, based on medical history and physical examination, must determine the type and severity of the UI in order to refer severe cases to the Urologist. Except for overactive bladder (OAB), non-pharmacological conservative treatment is the first approach to uncomplicated UI in females and males. Antimuscarinics are the only drugs that have demonstrated efficacy and safety in urge urinary incontinence (UUI) and OAB. In men with mixed symptoms, excluding severe obstruction cases, a combination therapy of alpha-blockers and antimuscarinics should be chosen (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Urinary Incontinence/diagnosis , Urinary Incontinence/therapy , Primary Health Care/methods , Primary Health Care/trends , Primary Health Care , Risk Factors , Algorithms , Urinary Incontinence/classification , Urinary Bladder, Overactive/diagnosis , Urinary Bladder, Overactive/therapy , Evidence-Based Medicine/methods , Evidence-Based Medicine/trends , Surveys and QuestionnairesABSTRACT
A pesar de la elevada incidencia de incontinencia urinaria (IU) existe una escasa sensibilización de los profesionales sanitarios hacia esta afección, que no es grave, pero que sí autolimita de forma importante la vida de las personas que la presentan. Las sociedades científicas de Atención Primaria (Sociedad Española de Médicos de Atención Primaria [SEMERGEN], Sociedad Española de Médicos Generales y de Familia [SEMG], Sociedad Española de Medicina de Familia y Comunitaria [semFYC]) y la Asociación Española de Urología [AEU]) han elaborado este documento de consenso con los objetivos de sensibilizar al médico de atención primaria y ayudarle a la evaluación diagnóstica, tratamiento y derivación al especialista de la IU. El primer objetivo desde atención primaria (AP) debe ser la detección de la IU, por lo que se recomienda realizar un cribado oportunista al menos, una vez a lo largo de la vida en mujeres asintomáticas > 40 años y en varones asintomáticos > 55 años. En la evaluación diagnóstica, basada en la anamnesis y la exploración física, se deberá determinar el tipo y gravedad de la IU con el objetivo de derivar al especialista los casos de IU complicada. Con excepción de la vejiga hiperactiva (VH), el tratamiento conservador no farmacológico constituye el abordaje principal de la IU no complicada, tanto en mujeres como en varones. En la IU de urgencia/VH (IUU/VH), los antimuscarínicos son los únicos fármacos que han demostrado eficacia y seguridad. En el caso de los varones con síntomas mixtos, excluyendo los casos de obstrucción severa, se debe optar por un tratamiento combinado de alfa-bloqueantes y antimuscarínicos (AU)
Despite the high incidence of urinary incontinence (UI), health professional awareness of this disease is low, which in itself is not serious but significantly limits the lives of the patients. The Primary Care associations, Sociedad Española de Médicos de Atención Primaria [SEMERGEN], Sociedad Española de Médicos Generales y de Familia [SEMG], Sociedad Española de Medicina de Familia y Comunitaria [semFYC]) along with the Asociación Española de Urología (EAU) have developed this consensus with the proposal of making GPs aware, and to help them in the diagnosis, treatment and referral to Urologists. The first goal in primary care must be the detection of UI, thus an opportunistic screening at least once in the lifetime of asymptomatic women > 40 years old and asymptomatic men > 55 years old. The diagnosis, based on medical history and physical examination, must determine the type and severity of the UI in order to refer severe cases to the Urologist. Except for overactive bladder (OAB), non-pharmacological conservative treatment is the first approach to uncomplicated UI in females and males. Antimuscarinics are the only drugs that have demonstrated efficacy and safety in urge urinary incontinence (UUI) and OAB. In men with mixed symptoms, excluding severe obstruction cases, a combination therapy of alpha-blockers and antimuscarinics should be chosen (AU)
Subject(s)
Humans , Urinary Incontinence/epidemiology , Mass Screening/methods , Primary Health Care/statistics & numerical data , Referral and Consultation , Muscarinic Antagonists/therapeutic use , Adrenergic alpha-Antagonists/therapeutic use , Medical History Taking/methods , Urinary Bladder, Overactive/drug therapyABSTRACT
Despite the high incidence of urinary incontinence (UI), health professional awareness of this disease is low, which in itself is not serious but significantly limits the lives of the patients. The Primary Care associations, Sociedad Española de Médicos de Atención Primaria [SEMERGEN], Sociedad Española de Médicos Generales y de Familia [SEMG], Sociedad Española de Medicina de Familia y Comunitaria [semFYC]) along with the Asociación Española de Urología (EAU) have developed this consensus with the proposal of making GPs aware, and to help them in the diagnosis, treatment and referral to Urologists. The first goal in primary care must be the detection of UI, thus an opportunistic screening at least once in the lifetime of asymptomatic women > 40 years old and asymptomatic men > 55 years old. The diagnosis, based on medical history and physical examination, must determine the type and severity of the UI in order to refer severe cases to the Urologist. Except for overactive bladder (OAB), non-pharmacological conservative treatment is the first approach to uncomplicated UI in females and males. Antimuscarinics are the only drugs that have demonstrated efficacy and safety in urge urinary incontinence (UUI) and OAB. In men with mixed symptoms, excluding severe obstruction cases, a combination therapy of alpha-blockers and antimuscarinics should be chosen.
Subject(s)
Primary Health Care , Referral and Consultation/standards , Urinary Incontinence/diagnosis , Urinary Incontinence/therapy , Algorithms , Female , Humans , Male , RecordsABSTRACT
Benign prostatic hyperplasia (BPH) is a high prevalence condition in men over 50 years that requires continued assistance between primary care and urology. Therefore, consensus around common referral criteria was needed to guide and support both levels. Medical history, symptom assessment with International Prostate Symptom Score (IPSS) questionnaire, digital rectal examination and prostate-specific antigen (PSA) measurement are diagnostic tests available for general practitioners that allow setting a correct BPH diagnose. Patients with an IPSS<8 should be monitored by evaluating them annually. Treatment with alpha-blockers and an evaluation at the first and third month is recommended in patients with an IPSS 8-20 and if the prostate is small, if the prostate size is large treatment with alpha-blockers or 5alpha-reductase inhibitors and evaluation at the third and six month is recommended, and in patients with a large prostate and a PSA >1.5 ng/ ml combined treatment and evaluation at the first and sixth month is recommended. Some clear criteria for referral to urology are established in this document, which help in the management of these patients. Those patients with BPH who do not show any improvement at the third month of treatment with alpha-blockers, or the sixth month with 5alpha-reductase inhibitors, will be referred to urology. Patients will also be referred to urology if they have lower urinary tract symptoms, a pathological finding during rectal examination, IPSS>20, PSA>10 ng/ml or PSA>4 ng/ml and free PSA<20% or if they are <50 years with suspected BHP, or if they have any urological complication.
