For the 2022 Non-neurogenic Male LUTS Guidelines, new and relevant evidence has been identified, collated, and appraised through a structured assessment of the literature. A broad and comprehensive literature search, covering all sections of the Male LUTS Guidelines was performed. The search was limited to studies representing high levels of evidence, i.e., systematic reviews with meta-analysis, randomised controlled trials (RCTs), and prospective non-randomised comparative studies, published in the English language. An additional literature search was performed for newly added section 5.6 Management of urinary incontinence in males. The number of unique records identified, retrieved, and screened for relevance for each section were:
- General Non-neurogenic Male LUTS Guidelines: 2,853 abstracts; 382 full texts; 77 new /updated references included
- Section 5.6 Management of urinary incontinence in males: 1,054 abstracts; 391 full texts; 144 new/updated references included
As a result of the searches, additional references and text updates have been incorporated throughout the text. Key changes in this edition include:
- Addition of section 5.2.7.3 α1-blockers + Beta-3 agonist, resulting in a new summary of evidence and recommendation:
Summary of evidence | LE |
Combination treatment with α1-blockers and mirabegron results in a slight decrease of number of voids and urgency episodes per day compared with α1-blockers. | 1b |
Adverse events of both drug classes are seen with combined treatment using α1-blockers and mirabegron | 1b |
Recommendation | Strength rating |
Use combination treatment of a α1-blocker with mirabegron in patients with persistent storage LUTS after treatment with α1-blockers monotherapy. | Weak |
Addition of 5.6 Management of male urinary incontinence. This section is a new edition to the 2022 EAU Non-neurogenic Male LUTS Guidelines and includes practical recommendations for urologists on the management of male urinary incontinence.