Back to overview

Male LUTS session dispels myths, explores causes and genetic link

Plenary Session “Male LUTS: Prevention, attention, intervention” led by Chairs Prof. Jean-Nicolas Cornu (FR) and Prof. Christian Gratzke (DE) explored non-prostate-related causes, examined the genetic link, and debunked myths.

Truth and lies
During the “Epidemiology and prevention” segment of the session, Prof. Mauro Gacci (IT) provided non-pharmacological strategies to avert the development of benign prostatic hyperplasia (BPH).

In his presentation “Non-pharmacologic prevention of BPH: Truth and lies”, he underscored the impact of diet, exercise, smoking, and alcohol intake on the risk of benign prostatic hyperplasia (BPH) progression and also examined its correlation to race and socioeconomic status.

Heavy smoking; increased consumption of beef, butter, margarine, and starch; and intake of sodium and zinc, are associated with BPH risk. At least a modest amount of physical activity; moderate alcohol consumption; intermittent fasting; and intake of micronutrients such as carotene, vitamin C, and iron have a protective effect against developing BPH.

Myths on BPH prevention such as increased sexual activity and the avoidance of bicycle use are debunked as ineffective according to available literature.

Read his full scientific article in the EAU24 Congress Newsletter here.

Genetic predisposition
“BPH is 15 years behind prostate cancer,” was one of the overarching points from the presentation “Genetic predisposition for BPH: Where do we stand?” by Prof. Martin Hennenberg (DE). He stated that translational relevance is limited for BPH. He added that the druggability of most genes is restricted by imbalanced side effects, costs, unknown organ-specificity, lacking efficacy (e.g., vitamin D receptor [VDR], progesterone), and inadequate innovative character (i.e., steroid metabolism). Prof. Hennenberg underscored that deeper characterisation of some identified genes is required.

Get more details in this scientific article in the EAU24 Congress Newsletter.

Epidemiology of male LUTS
In his presentation “Epidemiology of male LUTS: Not only the prostate”, Prof. Marcus Drake (GB) stated, “We need to consider multiple influences [that induce lower urinary tract symptoms (LUTS)] such as the bladder; the inflammatory process; the nature of the nerve supply and anatomical aspects; how fast and how much urine is produced; psychology; and overall health of each individual.”

Regarding the bladder, Prof. Drake said, “We should emphasise the fundamental nature of urgency as the driving symptom for overactive bladder (OAB).” Additionally, he mentioned underactive bladder (UAB), which he referred to as “the other direct bladder pathology.”

Concerning microbiome, Prof. Drake said that it is a mistake to focus on the species of the bacteria without considering what enzymatic potential they might have. Furthermore, on shared innervation, LUTS should be evaluated in patients with inflammatory bowel disease (IBD) by urologic-validated questionnaires for prompt diagnosis and early treatment.

Prof. Drake cited findings from a study (Chen J. et al, 2024) which showed that sleep-related disorders were associated with LUTS, hesitancy, incomplete emptying, incontinence, and nocturia in middle-aged and elderly males.

Considering the psychological makeup of patients is also important as adverse childhood events could indirectly cause urinary symptoms in adulthood.

On frailty, regarding patients with urological diseases, those with LUTS were found to have a high prevalence of frailty. Additionally, neurological disease can have urinary symptoms as an early feature for some conditions such as multiple system atrophy (MSA), early dementia, or early Parkinson’s disease, to name a few.

Visit the EAU24 Resource Centre to review congress presentations.