Differential Response to Medical Therapy for Male Lower Urinary Tract Symptoms

Abstract

Medical therapy has assumed a critical role in the treatment of male lower urinary tract symptoms (LUTS) secondary to bladder outlet obstruction. Targeting both bladder and prostate, these medications provide an effective means to manage LUTS for millions of men. However, significant proportion of men do not respond adequately to medical therapy and go on to surgical treatment of bladder outlet obstruction. In order to provide patients with appropriate therapy, prevent unnecessary exposure to drug side effects, and reduce medical costs, it is important to identify those men in whom medication will not be effective. In this review, we focus on the risk factors that predict failure of the common medical therapies for male LUTS. In addition, we describe recently discovered molecular targets that show promise for treatment of LUTS recalcitrant to conventional therapies.