Affiliation:
1. Department of Urology, ERN accredited centrum Ghent University Hospital Ghent Belgium
2. Department of Urology University Medical Center Utrecht Utrecht The Netherlands
3. Department of Urology University of Texas Southwestern Medical Center Dallas Texas USA
4. Department of Urology Apollo Hospital Hyderabad Telangana India
5. Departments of Medicine and Pharmacology and Chemical Biology University of Pittsburgh Pittsburgh Pennsylvania USA
Abstract
AbstractIntroductionLower urinary tract symptoms (LUTSs) are a diverse array of urinary and pelvic dysfunctions that can emerge from childhood, extend through adulthood, and persist into older age. This narrative review aims to provide a comprehensive perspective on the continuum of LUTS and shed light on the underlying mechanisms and clinical implications that span across the lower urinary tract.MethodsA panel of five experts from Belgium, the Netherlands, India, Denmark, and the United States participated in an intensive research to explore and pinpoint existing insights into the lifelong concept of LUTS, particularly at the pelvic level. The experts reviewed the existing literature and held a webinar to discuss their findings.ResultsChildhood LUTS can persist, resolve, or progress into bladder underactivity, dysfunctional voiding, or pain syndromes. The Lifelong character can be explained by pelvic organ cross‐talk facilitated through complex neurological and nonneurological interactions. At the molecular level, the role of vasopressin receptors in the bladder's modulation and their potential relevance to therapeutic strategies for LUTS are explored. Frailty emerges as a parallel concept to lifelong LUTS, with a complex and synergistic relationship. Frailty, not solely an age‐related condition, accentuates LUTS severity with insufficient evidence regarding the effectiveness and safety profile of the available therapeutic modalities.ConclusionUnderstanding lifelong LUTSs offers insights into genetic, anatomical, neurological, and molecular mechanisms. Further research could identify predictive biomarkers, elucidate the role of clinically translatable elements in pelvic cross‐talk, and uncover molecular signatures for personalized management.
Funder
Ferring
Universitair Ziekenhuis Gent
Astellas Pharma
Subject
Urology,Neurology (clinical)