Urinary Health is a conventional point of emphasis for HolSpan and most urological practices. It is helpful to become familiar with basic terms and concepts to navigate the urinary system better. General problems urinating are termed Lower Urinary Tract Symptoms (LUTS). Other terms that are commonly used are “enlarged prostate” in men and “overactive bladder” in both women and men.
These symptoms can be better understood when further subdivided into:
Obstructive LUTS
These symptoms can be visualized as problems that “block” flow. Imagery of a pinched garden hose or clogged drain illustrates obstructive problems well for many patients. These symptoms are more common in men but can also be present in women.
Storage LUTS (also referred to as irritative symptoms or overactive bladder, OAB)
These symptoms can be visualized as “going” concerns (going often during the day or night). Hearing running water or behavioral triggers, such as placing the house key into the front door, can trigger these symptoms in some patients. These types of symptoms can be common in both women and men.
LUTS in men are typically attributed to Benign Prostatic Hypertrophy (BPH). Benign Prostatic Hypertrophy (BPH) is typically referred to as having an “enlarged prostate” or “prostate problems.” Historically, it has been understood as a condition where the prostate, typically enlarging as a person ages, creates more resistance to urine flow, leading to a decrease in flow efficiency. This results in blockage and obstructive lower urinary tract symptoms (LUTS).
Conditions affecting the urethra and pelvic floor muscles can also lead to similar symptoms. These are addressed within the conventional medicine component of HolSpan:
Overactive bladder is a collection of mainly storage symptoms. Symptoms commonly worsen with age as the “elasticity” of the bladder (compliance), tends to decrease. Patients typically report, “I can’t hold it like I used to.”
Urinary health is an often overlooked aspect of health until problems arise that become bothersome. The conventional urology component of HolSpan typically sees patients with varying LUTS. Like many areas of focus within HolSpan, urinary health may be a window into the broader health of the patient. Lifestyle and behavioral approaches, with a heavy emphasis on what and when we drink and eat, can be very impactful for patients.
Conventional approaches to treatment are commonly addressed with a heavy emphasis on medicines and surgeries. In many patients, these interventions are impactful when used in well-selected patients experiencing significant bother from the symptoms. The conventional urology component of HolSpan is skilled at helping patients decide if and when medications or minimally invasive procedures are appropriate for them.
Lifestyle factors that are often overlooked contribute to LUTS. The initial steps within treatment guidelines for BPH and overactive bladder emphasize lifestyle modifications as first-line options. HolSpan works with patients to build a base with lifestyle interventions. If the conventional approaches are to be viewed as the science aspect of medicine, the lifestyle component is very much the complementary art. HolSpan attempts to balance the best of both approaches to deliver the best possible patient outcomes.
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