European Association of Urology Guidelines on the Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 2: Underactive Bladder, Bladder Outlet Obstruction, and Nocturia

Salvador Arlandis; Kari Bø; Hanny Cobussen-Boekhorst; Elisabetta Costantini; Monica de Heide; Fawzy Farag; Jan Groen; Markos Karavitakis; Marie Carmela Lapitan; Margarida Manso; Serenella Monagas Arteaga; Arjun K. Nambiar; Aisling Nic An Riogh; Eabhann O'Connor; Muhammad Imran Omar; Benoit Peyronnet; Veronique Phé; Vasileios I. Sakalis; Néha Sihra; Lazaros Tzelves; Mary Lynne van Poelgeest-Pomfret; Tine W.L. van den Bos; Huub van der Vaart; Christopher K. Harding

doi:10.1016/j.eururo.2022.01.044

European Association of Urology Guidelines on the Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 2: Underactive Bladder, Bladder Outlet Obstruction, and Nocturia

Salvador Arlandis^*, Kari Bø, Hanny Cobussen-Boekhorst, Elisabetta Costantini, Monica de Heide, Fawzy Farag, Jan Groen, Markos Karavitakis, Marie Carmela Lapitan, Margarida Manso, Serenella Monagas Arteaga, Arjun K. Nambiar, Aisling Nic An Riogh, Eabhann O'Connor, Muhammad Imran Omar, Benoit Peyronnet, Veronique Phé, Vasileios I. Sakalis, Néha Sihra, Lazaros TzelvesMary Lynne van Poelgeest-Pomfret, Tine W.L. van den Bos, Huub van der Vaart, Christopher K. Harding

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

12 Citations (Scopus)

Abstract

Context: Female lower urinary tract symptoms (LUTS) are a common presentation in urological practice. Thus far, only a limited number of female LUTS conditions have been included in the European Association of Urology (EAU) guidelines compendium. The new non-neurogenic female LUTS guidelines expand the remit to include these symptoms and conditions.

Objective: To summarise the management of underactive bladder (UAB), bladder outlet obstruction (BOO), and nocturia in females.

Evidence acquisition: The literature search was updated in September 2021 and evidence synthesis was conducted using modified GRADE approach as outlined for all EAU guidelines. A new systematic review on BOO was carried out by the panel for purposes of this guideline.

Evidence synthesis: The important considerations for informing guideline recommendations are presented, along with a summary of all the guideline recommendations.

Conclusions: Non-neurogenic female LUTS are an important presentation of urological dysfunction. Initial evaluation, diagnosis, and management should be carried out in a structured and logical fashion on the basis of the best available evidence. This guideline serves to present this evidence to practising urologists and other health care providers in an easily accessible and digestible format.

Patient summary: This report summarises the main recommendations from the European Association of Urology guideline on symptoms and diseases of the female lower urinary tract (bladder and urethra) not associated with neurological disease. We cover recommendations related to the treatment of underactive bladder, obstruction of the bladder outlet, and nighttime urination.

Original language	English
Pages (from-to)	60-70
Number of pages	11
Journal	European Urology
Volume	82
Issue number	1
Early online date	9 Jun 2022
DOIs	https://doi.org/10.1016/j.eururo.2022.01.044
Publication status	Published - Jul 2022

Bibliographical note

Funding Information:
Financial disclosures: Salvador Arlandis certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: Salvador Arlandis has received company speaker honoraria from Astellas Pharma S.A., Bayer Hispania S.L., and Lacer-Holliste; has received honoraria for consultation from Presurgy S.L., Boston Scientific Europe, and Coloplast Productos Medicos; has participated in clinical trials by GlaxoSmithKline, Astellas, Ipsen, and Urovant; has received travel grants from Astellas Pharma S.A., WellSpect, Lacer, and Rovi; and has been a company consultant for Lacer Laboratories. Christopher K. Harding is a company consultant for Teleflex Medical; has received speaker honoraria from Astellas, Allergan, and Medtronic; has participated in clinical trials by Medtronic; has received fellowship and travel grants from Medtronic; and has received research support from the National Institute for Health Research and The Urological Foundation. Marie Carmela Lapitan has received speaker honoraria from Astellas, AstraZeneca, and GSK. Elisabetta Costantini has received research support from S&R Farmaceutici. Jan Groen has participated in clinical trials by Neuspera Medical Inc. Veronique Phé has received speaker honoraria from Medtronic and Viatris and is a company consultant for Allergan and Coloplast. Huub van der Vaart has ownership interest in a patent with Ligalli B.V.; is a director of Berman Clinics; receives royalties from NVOG; is participating in clinical trials by UroGyn; and receives research support from ZonMw and NWO-TTW. Benoit Peyronnet is a company consultant for Boston Scientific. Lazaros Tzelves receives research support from the National and Kapodistrian University of Athens and the ASCAPE Project and is participating in a clinical trial by the ASCAPE Project. The remaining authors have nothing to disclose.

Keywords

Bladder outlet obstruction
Conservative management
European Association of Urology guidelines
Female lower urinary tracts symptoms
Nocturia
Underactive bladder

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© 2022. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
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Cite this

Arlandis, S., Bø, K., Cobussen-Boekhorst, H., Costantini, E., de Heide, M., Farag, F., Groen, J., Karavitakis, M., Lapitan, M. C., Manso, M., Arteaga, S. M., Nambiar, A. K., Riogh, A. N. A., O'Connor, E., Omar, M. I., Peyronnet, B., Phé, V., Sakalis, V. I., Sihra, N., ... Harding, C. K. (2022). European Association of Urology Guidelines on the Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 2: Underactive Bladder, Bladder Outlet Obstruction, and Nocturia. European Urology, 82(1), 60-70. https://doi.org/10.1016/j.eururo.2022.01.044

European Association of Urology Guidelines on the Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 2: Underactive Bladder, Bladder Outlet Obstruction, and Nocturia. / Arlandis, Salvador; Bø, Kari; Cobussen-Boekhorst, Hanny et al.
In: European Urology, Vol. 82, No. 1, 07.2022, p. 60-70.

Research output: Contribution to journal › Article › peer-review

Arlandis, S, Bø, K, Cobussen-Boekhorst, H, Costantini, E, de Heide, M, Farag, F, Groen, J, Karavitakis, M, Lapitan, MC, Manso, M, Arteaga, SM, Nambiar, AK, Riogh, ANA, O'Connor, E, Omar, MI, Peyronnet, B, Phé, V, Sakalis, VI, Sihra, N, Tzelves, L, van Poelgeest-Pomfret, ML, van den Bos, TWL, van der Vaart, H & Harding, CK 2022, 'European Association of Urology Guidelines on the Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 2: Underactive Bladder, Bladder Outlet Obstruction, and Nocturia', European Urology, vol. 82, no. 1, pp. 60-70. https://doi.org/10.1016/j.eururo.2022.01.044

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title = "European Association of Urology Guidelines on the Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 2: Underactive Bladder, Bladder Outlet Obstruction, and Nocturia",

abstract = "Context: Female lower urinary tract symptoms (LUTS) are a common presentation in urological practice. Thus far, only a limited number of female LUTS conditions have been included in the European Association of Urology (EAU) guidelines compendium. The new non-neurogenic female LUTS guidelines expand the remit to include these symptoms and conditions. Objective: To summarise the management of underactive bladder (UAB), bladder outlet obstruction (BOO), and nocturia in females. Evidence acquisition: The literature search was updated in September 2021 and evidence synthesis was conducted using modified GRADE approach as outlined for all EAU guidelines. A new systematic review on BOO was carried out by the panel for purposes of this guideline. Evidence synthesis: The important considerations for informing guideline recommendations are presented, along with a summary of all the guideline recommendations. Conclusions: Non-neurogenic female LUTS are an important presentation of urological dysfunction. Initial evaluation, diagnosis, and management should be carried out in a structured and logical fashion on the basis of the best available evidence. This guideline serves to present this evidence to practising urologists and other health care providers in an easily accessible and digestible format.Patient summary: This report summarises the main recommendations from the European Association of Urology guideline on symptoms and diseases of the female lower urinary tract (bladder and urethra) not associated with neurological disease. We cover recommendations related to the treatment of underactive bladder, obstruction of the bladder outlet, and nighttime urination.",

keywords = "Bladder outlet obstruction, Conservative management, European Association of Urology guidelines, Female lower urinary tracts symptoms, Nocturia, Underactive bladder",

author = "Salvador Arlandis and Kari B{\o} and Hanny Cobussen-Boekhorst and Elisabetta Costantini and {de Heide}, Monica and Fawzy Farag and Jan Groen and Markos Karavitakis and Lapitan, {Marie Carmela} and Margarida Manso and Arteaga, {Serenella Monagas} and Nambiar, {Arjun K.} and Riogh, {Aisling Nic An} and Eabhann O'Connor and Omar, {Muhammad Imran} and Benoit Peyronnet and Veronique Ph{\'e} and Sakalis, {Vasileios I.} and N{\'e}ha Sihra and Lazaros Tzelves and {van Poelgeest-Pomfret}, {Mary Lynne} and {van den Bos}, {Tine W.L.} and {van der Vaart}, Huub and Harding, {Christopher K.}",

note = "Funding Information: Financial disclosures: Salvador Arlandis certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: Salvador Arlandis has received company speaker honoraria from Astellas Pharma S.A., Bayer Hispania S.L., and Lacer-Holliste; has received honoraria for consultation from Presurgy S.L., Boston Scientific Europe, and Coloplast Productos Medicos; has participated in clinical trials by GlaxoSmithKline, Astellas, Ipsen, and Urovant; has received travel grants from Astellas Pharma S.A., WellSpect, Lacer, and Rovi; and has been a company consultant for Lacer Laboratories. Christopher K. Harding is a company consultant for Teleflex Medical; has received speaker honoraria from Astellas, Allergan, and Medtronic; has participated in clinical trials by Medtronic; has received fellowship and travel grants from Medtronic; and has received research support from the National Institute for Health Research and The Urological Foundation. Marie Carmela Lapitan has received speaker honoraria from Astellas, AstraZeneca, and GSK. Elisabetta Costantini has received research support from S&R Farmaceutici. Jan Groen has participated in clinical trials by Neuspera Medical Inc. Veronique Ph{\'e} has received speaker honoraria from Medtronic and Viatris and is a company consultant for Allergan and Coloplast. Huub van der Vaart has ownership interest in a patent with Ligalli B.V.; is a director of Berman Clinics; receives royalties from NVOG; is participating in clinical trials by UroGyn; and receives research support from ZonMw and NWO-TTW. Benoit Peyronnet is a company consultant for Boston Scientific. Lazaros Tzelves receives research support from the National and Kapodistrian University of Athens and the ASCAPE Project and is participating in a clinical trial by the ASCAPE Project. The remaining authors have nothing to disclose. ",

year = "2022",

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doi = "10.1016/j.eururo.2022.01.044",

language = "English",

volume = "82",

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journal = "European Urology",

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TY - JOUR

T1 - European Association of Urology Guidelines on the Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 2

T2 - Underactive Bladder, Bladder Outlet Obstruction, and Nocturia

AU - Arlandis, Salvador

AU - Bø, Kari

AU - Cobussen-Boekhorst, Hanny

AU - Costantini, Elisabetta

AU - de Heide, Monica

AU - Farag, Fawzy

AU - Groen, Jan

AU - Karavitakis, Markos

AU - Lapitan, Marie Carmela

AU - Manso, Margarida

AU - Arteaga, Serenella Monagas

AU - Nambiar, Arjun K.

AU - Riogh, Aisling Nic An

AU - O'Connor, Eabhann

AU - Omar, Muhammad Imran

AU - Peyronnet, Benoit

AU - Phé, Veronique

AU - Sakalis, Vasileios I.

AU - Sihra, Néha

AU - Tzelves, Lazaros

AU - van Poelgeest-Pomfret, Mary Lynne

AU - van den Bos, Tine W.L.

AU - van der Vaart, Huub

AU - Harding, Christopher K.

N1 - Funding Information: Financial disclosures: Salvador Arlandis certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: Salvador Arlandis has received company speaker honoraria from Astellas Pharma S.A., Bayer Hispania S.L., and Lacer-Holliste; has received honoraria for consultation from Presurgy S.L., Boston Scientific Europe, and Coloplast Productos Medicos; has participated in clinical trials by GlaxoSmithKline, Astellas, Ipsen, and Urovant; has received travel grants from Astellas Pharma S.A., WellSpect, Lacer, and Rovi; and has been a company consultant for Lacer Laboratories. Christopher K. Harding is a company consultant for Teleflex Medical; has received speaker honoraria from Astellas, Allergan, and Medtronic; has participated in clinical trials by Medtronic; has received fellowship and travel grants from Medtronic; and has received research support from the National Institute for Health Research and The Urological Foundation. Marie Carmela Lapitan has received speaker honoraria from Astellas, AstraZeneca, and GSK. Elisabetta Costantini has received research support from S&R Farmaceutici. Jan Groen has participated in clinical trials by Neuspera Medical Inc. Veronique Phé has received speaker honoraria from Medtronic and Viatris and is a company consultant for Allergan and Coloplast. Huub van der Vaart has ownership interest in a patent with Ligalli B.V.; is a director of Berman Clinics; receives royalties from NVOG; is participating in clinical trials by UroGyn; and receives research support from ZonMw and NWO-TTW. Benoit Peyronnet is a company consultant for Boston Scientific. Lazaros Tzelves receives research support from the National and Kapodistrian University of Athens and the ASCAPE Project and is participating in a clinical trial by the ASCAPE Project. The remaining authors have nothing to disclose.

PY - 2022/7

Y1 - 2022/7

N2 - Context: Female lower urinary tract symptoms (LUTS) are a common presentation in urological practice. Thus far, only a limited number of female LUTS conditions have been included in the European Association of Urology (EAU) guidelines compendium. The new non-neurogenic female LUTS guidelines expand the remit to include these symptoms and conditions. Objective: To summarise the management of underactive bladder (UAB), bladder outlet obstruction (BOO), and nocturia in females. Evidence acquisition: The literature search was updated in September 2021 and evidence synthesis was conducted using modified GRADE approach as outlined for all EAU guidelines. A new systematic review on BOO was carried out by the panel for purposes of this guideline. Evidence synthesis: The important considerations for informing guideline recommendations are presented, along with a summary of all the guideline recommendations. Conclusions: Non-neurogenic female LUTS are an important presentation of urological dysfunction. Initial evaluation, diagnosis, and management should be carried out in a structured and logical fashion on the basis of the best available evidence. This guideline serves to present this evidence to practising urologists and other health care providers in an easily accessible and digestible format.Patient summary: This report summarises the main recommendations from the European Association of Urology guideline on symptoms and diseases of the female lower urinary tract (bladder and urethra) not associated with neurological disease. We cover recommendations related to the treatment of underactive bladder, obstruction of the bladder outlet, and nighttime urination.

AB - Context: Female lower urinary tract symptoms (LUTS) are a common presentation in urological practice. Thus far, only a limited number of female LUTS conditions have been included in the European Association of Urology (EAU) guidelines compendium. The new non-neurogenic female LUTS guidelines expand the remit to include these symptoms and conditions. Objective: To summarise the management of underactive bladder (UAB), bladder outlet obstruction (BOO), and nocturia in females. Evidence acquisition: The literature search was updated in September 2021 and evidence synthesis was conducted using modified GRADE approach as outlined for all EAU guidelines. A new systematic review on BOO was carried out by the panel for purposes of this guideline. Evidence synthesis: The important considerations for informing guideline recommendations are presented, along with a summary of all the guideline recommendations. Conclusions: Non-neurogenic female LUTS are an important presentation of urological dysfunction. Initial evaluation, diagnosis, and management should be carried out in a structured and logical fashion on the basis of the best available evidence. This guideline serves to present this evidence to practising urologists and other health care providers in an easily accessible and digestible format.Patient summary: This report summarises the main recommendations from the European Association of Urology guideline on symptoms and diseases of the female lower urinary tract (bladder and urethra) not associated with neurological disease. We cover recommendations related to the treatment of underactive bladder, obstruction of the bladder outlet, and nighttime urination.

KW - Bladder outlet obstruction

KW - Conservative management

KW - European Association of Urology guidelines

KW - Female lower urinary tracts symptoms

KW - Nocturia

KW - Underactive bladder

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European Association of Urology Guidelines on the Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 2: Underactive Bladder, Bladder Outlet Obstruction, and Nocturia

Abstract

Bibliographical note

Keywords

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