Abstract

To review recent data on the prevalence and treatment of the symptom of urgency in men with benign prostatic enlargement (BPE). In recent years, researchers have moved to separate out individual lower urinary tract symptoms (LUTS) to see the individual impact. A recent registry trial put the prevalence of urgency at 38% in men with BPE. Other studies have reported urgency present in 64% of men with LUTS. While urgency is not as frequent a complaint in BPE as nocturia and frequency, it does have an impact on health-related quality of life. It is not increased in men with diabetes or the metabolic syndrome. Contributing factors may include prostate inflammation and decreased bladder blood flow from outlet obstruction. While some response is seen with treatment with alpha-blockers, more recently, anticholinergic and beta 3 medications are being used for refractory urgency in men with BPE. Urinary urgency is commonly reported in men with benign prostatic enlargement and is just beginning to be better evaluated with screening tools commonly used in overactive bladder patients. Specific medical therapy for urgency is helping to improve the response rate above traditional BPE therapy.

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