Ep. 293 Clinical Approaches to Managing Male LUTS with Dr. Craig Comiter and Dr. Ben Brucker

When a male patient presents with lower urinary tract symptoms, should you blame the bladder or bust the prostate? In this SUFU-sponsored episode of BackTable Urology, Dr. Benjamin Brucker (NYU) and Dr. Craig Comiter (Stanford) join host Dr. Chris Tenggardjaja (Kaiser Permanente) for a discussion on evaluating and treating male LUTS using a bladder-and-outlet framework.

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This podcast was developed in collaboration with:

Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU)
https://sufuorg.com/home.aspx

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SYNPOSIS

Through a case-based approach, they review initial evaluation strategies including symptom history, validated questionnaires, uroflowmetry, post-void residual measurement, and when tools like voiding diaries can help clarify the diagnosis. The conversation then moves to management, outlining a stepwise approach from behavioral interventions and medications to surgical options when symptoms persist. The doctors discuss how prostate anatomy, side effect profiles, and patient priorities guide treatment selection, when urodynamics may add diagnostic clarity, and why addressing outlet obstruction early may help prevent more difficult-to-treat bladder dysfunction over time.

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TIMESTAMPS

00:00 - Introduction
06:31 - Workup for Frequency and Nocturia
11:41 - When to Use a Voiding Diary
19:18 - Behavioral Therapy
26:40 - Post-Finasteride Syndrome
30:03 - Surgical Options
44:41 - Nocturia Counseling
47:32 - Botox With Outlet Surgery
49:47 - When to Order Urodynamics
54:14 - Bladder or Prostate?

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RESOURCES

Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU)
https://sufuorg.com/home