Dr. Massimo Lazzeri, Urologist on Prof. Giorgio Guazzoni’s team, was among the speakers at the annual meeting of the European Association of Urology (EAU). The meeting was held in Madrid from March 20th to March 24th. During his speech titled “LUTS therapy: single or married”, he illustrated the benefits resulting from a new methodological approach to treating lower urinary tract symptoms (LUTS). About 60% of men over the age of 50 are affected by these symptoms and they are not always associated with prostate disease. A proper evaluation enables patients to be properly selected for surgical intervention.
Why is a change in perspective important for treating lower urinary tract symptoms (LUTS)?
“Lower urinary tract symptoms (difficult urination, urgency, incomplete emptying of the bladder) affect 60% of men over the age of 50. Patients with these symptoms are usually labeled as having prostate problems and such assumptions can lead to assessment errors made by the physician. Some patients may not even need to undergo surgery. In fact, there is a poor correlation between lower urinary tract symptoms and prostate disease – explains Dr. Lazzeri. Urethra strictures and overactive bladder syndrome, whose symptoms are similar, may be confused with benign prostatic hypertrophy. Further complicating the situation may be symptoms such as urinary problems and erectile disorders in a large number of men.”
What are some therapeutic approaches to treating lower urinary tract symptoms?
“In the past, lower urinary tract symptoms were linked with benign prostatic hypertrophy – explains Dr. Lazzeri. Treatment options always had a “single-oriented” approach and were aimed to treat a single disease. A change in perspective known as “married-oriented” approach introduced a new concept that involved combining therapeutic approaches.”
What are the differences between the two therapeutic approaches?
“With the “single-oriented” approach says Dr. Lazzeri – a drug corresponds to a particular approach to treating a particular disease. With the “married-oriented” approach, more medications can be combined, each indicated for treating a single problem yet working together. With the “marriage-in-single” approach, however, the patient is given a medication with a mechanism suitable to treating most disorders linked to the whole bladder and prostate. For example, we now know that the drugs commonly used to treat erectile dysfunction by acting on the vasculature, are also effective in treating urinary dysfunction. Hence, we have developed medical therapies by administering a single dose to treat a single disorder, a combination of two drugs for two targets, as well as a single drug with a single mechanism to treating more targets. These medical therapies involve treatment of organs through body therapy.”
What are the benefits of a change in perspective?
“A change in perspective allows physicians to better define medical cases. It makes it possible for them to properly select patients in need of medical treatment and those in need of surgical treatment. The advantage of this approach is avoiding unnecessary invasive treatments and better functional outcomes in selected patients for surgery. Nowadays, for patients who need to undergo surgery, a minimally invasive endoscopic approach is available at our facility. The medical culture in this area can also make a difference.”