JAMA Clinical Reviews Managing Lower Urinary Tract Symptoms in Men
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Jul 14, 2025 John T. Wei, a Professor of Urology at the University of Michigan, joins Mary M. McDermott to dive into the challenges of lower urinary tract symptoms in men over 50. They highlight that about 40% of older men face issues like urinary urgency and frequency, significantly impacting their lives. The discussion covers diagnostic strategies, the effectiveness of pharmacologic treatments, and the importance of patient feedback. Wei also shares insights on behavioral interventions and minimally invasive surgical options for those with benign prostatic hyperplasia.
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Causes of Lower Urinary Symptoms
- Lower urinary tract symptoms in men are mainly caused by prostate enlargement or an overactive bladder.
- These two physiological problems affect urination especially as men age.
Prevalence and Risks of Symptoms
- Around 40% of men over 50 experience urinary symptoms affecting quality of life.
- Histologically, up to 90% of men in their 80s have benign prostate hyperplasia.
Symptom-Based Management Approach
- Distinguishing obstruction from overactive bladder is challenging, even for urologists.
- Management focuses on symptoms rather than definitive diagnosis.