Review article
Modern-day Management of Male Lower Urinary Tract Symptoms
Bojan Sudarević
Abstract
Lower urinary tract symptoms (LUTS) in men are a common clinical problem that significantly affects quality of life, particularly in the elderly population. Although traditionally attributed almost exclusively to prostatic enlargement, comprehensive diagnostic evaluation must also consider a broad differential diagnosis, including neurogenic bladder dysfunction, urethral strictures, and systemic disorders such as diabetes mellitus and cardiac decompensation. In addition to detailed diagnostics, the contemporary management of LUTS in men associated with benign prostatic hyperplasia (BPH) emphasizes an individualized, patient-centered approach, incorporating the use of novel minimally invasive therapeutic modalities. Clinical assessment should begin with a thorough medical history, standardized questionnaires such as the International Prostate Symptom Score (IPSS), physical examination and laboratory and ultrasound tests, with uroflowmetry serving as an objective functional evaluation of LUTS severity and treatment outcomes. Management strategies encompass conservative and behavioral interventions with lifestyle modifications, pharmacotherapy (alpha-blockers, 5-alpha-reductase inhibitors, antimuscarinics and beta-3 adrenergic agonists) and surgical procedures (the traditional “open” surgery, the endoscopic “gold standard” — transurethral resection of the prostate and modern minimally invasive procedures such as ablation or enucleation of the prostate using various energy sources). New approaches such as ablation and laser techniques allow for shorter hospital stay and faster recovery, with reduced complication rates. The goal of contemporary management of LUTS secondary to BPH is to achieve personalized, effective and safe treatment, ensuring preservation of lower urinary tract function and optimization of the patient’s quality of life.
Keywords
lower urinary tract symptoms, benign prostatic hyperplasia, clinical practice guideline
Hrčak ID:
345158
URI
Publication date:
26.2.2026.
Visits: 370 *