Focus on lower urinary tract symptoms: nomenclature, diagnosis, and treatment options: highlights from the 5th international consultation on benign prostatic hyperplasia june 25-27, 2000, paris, france. (2001)

Hardly any area of interest in urology has undergone as much change in the therapeutic armamentarium over the past decade as the treatment of lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). In the past, surgical management, most commonly transurethral resection of the prostate (TURP), was the mainstay of treatment for all patients with bothersome symptoms. The 1990s brought an array of medical interventions as well as modifications of traditional surgery and minimally invasive treatments, including transurethral microwave thermotherapy (TUMT), transurethral needle ablation of the prostate (TUNA), and others. Some have already been forgotten.

In the summer of 1991, a meeting was organized in Paris, France, to bring together experts from around the world to prepare reports and make recommendations on the most pressing issues in what then was called “prostatism” and BPH: basic sciences, epidemiology, pathophysiology, diagnosis, and therapeutic management. Within a year of the meeting, proceedings were published and became quickly one of the most widely utilized reference books in the field. New developments prompted additional consultations in alternating years, and the 5th International Consultation on BPH convened again in Paris from June 25th through June 27th, led by Dr. Aso (Japan) as honorary president, Professor Chatelain (France), and three Vice Chairmen, Professor Denis from Belgium, Professor Foo from Singapore, and Dr. John D. McConnell from the USA.

The fourteen committees were led by international experts and consisted of recognized opinion leaders in the field. The committees presented their findings and recommendations to the other panels as well as to the large international audience at the Palais de Congres in Paris. The committees dealt with the epidemiology and natural history of BPH (Chairman, Professor P. Boyle), the economics of BPH (Chairman, Dr. M. Naslund), regulation of prostate growth (Chairman, Professor C.H. Lee), pathophysiology of bladder obstruction in aging men (Chairman, Professor J. Nordling), initial evaluation of LUTS (Chairman, Dr. M. Resnick), quantification of symptoms, quality of life, and sexuality (Chairman, Dr. M. Barry), the urodynamics of LUTS (Chairman, Mr. P. Abrams), detection of prostate cancer in patients with BPH (Chairman, Dr. M. Brawer), clinical research criteria (Chairman, Dr. C. Roehrborn), interventional therapy (Chairman, Professor F. DeBruyne), endocrine treatment (Chairman, Professor G. Bartsch), alpha-blocker therapy (Chairman, Professor A. Jardin), other medical therapy (Chairman, Professor K. Dreikorn), and educational issues (Chairman, Dr. J. Corriere). After the individual committees gave their recommendations, the committee Chairmen met again in closed session to develop recommendations regarding the diagnosis and treatment of LUTS and BPH in a consensus process.

Rapid developments in the field have mandated frequent updates, and the year 2000 was no different. The current recommendations will no doubt also have to be periodically re-evaluated in the light of clinical experience and technological progress.