Chapple Christopher R, Wein Alan J, Abrams Paul, Dmochowski Roger R, Giuliano François, Kaplan Steven A, McVary Kevin T, Roehrborn Claus G
The Royal Hallamshire Hospital, Sheffield, UK.
Eur Urol. 2008 Sep;54(3):563-9. doi: 10.1016/j.eururo.2008.03.109. Epub 2008 Apr 8.
The term "lower urinary tract symptoms" (LUTS) was introduced to dissociate male urinary symptoms from any implied site of symptom origin, such as the prostate.
To consider a more expansive view of LUTS, moving beyond an organocentric focus.
Review of the available literature by a consensus panel.
A consensus group reviewed the literature and developed a conceptual framework to facilitate research and clinical practice in patients with LUTS, following steps outlined in the Delphi procedure. Committee discussion, with presentations and review of existing literature and knowledge at four separate occasions, and extensive review and discussion of draft documents encapsulating group views followed. Consensus group findings included evidence that LUTS increase with age and are prevalent in both male and female patients, with differences in the prevalence of individual storage, voiding, and postmicturition symptoms representing underlying pathophysiologic factors between the sexes. Additionally, it was recognised that patients often have underlying and overlapping pathophysiologic mechanisms that may be related to the expression of LUTS and that this global approach to LUTS reflects our contemporary recognition of the lower urinary tract as an integrated functional unit. To improve the current management of patients, education and awareness regarding LUTS, its causes, and associated comorbidities are needed. Major limitations of this work are the potential interpretive bias introduced by prior perceptions and the nature of the study populations drawn conventionally from secondary care.
In conclusion, it is misleading to attribute individual symptoms to sex differences or to a specific underlying organ. LUTS are a non-sex-specific, non-organ-specific group of symptoms, which are sometimes age-related and progressive. A need exists to increase education and awareness regarding LUTS, its causes, and associated comorbidities, and to assess and treat men and women for all LUTS, not just selected symptoms.
引入“下尿路症状”（LUTS）这一术语，以将男性泌尿系统症状与任何隐含的症状起源部位（如前列腺）区分开来。
考虑对LUTS采取更广泛的观点，超越以器官为中心的关注点。
由一个共识小组对现有文献进行综述。
一个共识小组对文献进行了综述，并制定了一个概念框架，以促进LUTS患者的研究和临床实践，遵循德尔菲法中概述的步骤。委员会进行了讨论，在四个不同场合进行了现有文献和知识的展示与综述，并对封装小组观点的文件草案进行了广泛的综述和讨论。共识小组的研究结果包括，有证据表明LUTS随年龄增长而增加，在男性和女性患者中都很普遍，个体储尿、排尿和排尿后症状的患病率差异代表了两性之间潜在的病理生理因素。此外，人们认识到患者通常有潜在的和重叠的病理生理机制，这些机制可能与LUTS的表现有关，并且这种对LUTS的整体方法反映了我们目前将下尿路视为一个综合功能单位的认识。为了改善目前对患者的管理，需要对LUTS及其病因和相关合并症进行教育和提高认识。这项工作的主要局限性是先前观念引入的潜在解释性偏差以及传统上从二级护理中选取的研究人群的性质。
总之，将个体症状归因于性别差异或特定的潜在器官是有误导性的。LUTS是一组非性别特异性、非器官特异性的症状，有时与年龄有关且呈进行性发展。有必要增加对LUTS及其病因和相关合并症的教育和认识，并对所有LUTS的男性和女性进行评估和治疗，而不仅仅是针对选定的症状。
