The ManVsProstate MANifesto: The Preservation of Bladder Health for BPH BPO
Wayne Kuang MD
Empowering bladders in the BPH fight against prostates | #WhatAboutMyBladder | Futurist | Street Busker | Author
Terminology
AUA: American Urological Association | AUR: Acute Urinary Retention (Stage IV) | BPH: Benign Prostatic Hyperplasia (Histology) | BPE: Benign Prostatic Enlargement | BPO: Benign Prostatic Obstruction (Stage I) | DOA: Detrusor Overactivity (Stage II) | DUA: Detrusor Underactivity (Stage V) | EAU: European Association of Urology | LUTS: Lower Urinary Tract Symptoms | MANifesto: a public declaration of views | MVP: ManVsProstate | NICE: National Institute for Health and Care Excellence | Precept: a general rule to nudge behavior or thought | Screening: Testing of the asymptomatic to identify at-risk bladders |?
Introduction
The ManVsProstate MANifesto is an expression of support and appreciation for the academic leadership and their time, effort and expertise that are required to craft the global BPH BPO Guidelines (American Urological Association, European Association of Urology and the National Institute for Health and Clinical Excellence).?
The MVP Vision is “all BPH BPO patients are living lives that are well-lived, chemical-free and catheter-free.”?
The MVP Mission is “to empower these patients with the educational experience to make the best decision about their prostate even faster by highlighting possible consequences of choosing not to take definitive action.”
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The precepts below are for the Guideline Committees to review and incorporate where they believe there is merit. What was once a whisper has grown organically since 2021 into a thoughtful global voice to prioritize the Preservation of Bladder Health to stem the impending worldwide surge of Late-Stage BPH BPO. This MANifesto aims to accelerate the transition from LUTS-focused to bladder-centric guidelines. (Groves 2013 Prostate Cancer and Prostatic Diseases; Whiting 2023 Trends in Urology & Men's Health; Cindolo 2023 Prostate Cancer and Prostatic Diseases).This MANifesto highlights the need to optimize the efficiency of the PRE-treatment phase of the care pathway. This can be achieved by maximally leveraging the following measures: Bladder Health Screening, Risk-Stratification, Counseling and Baselines.
ManVsProstate recognizes that we Defenders of the Detrusor treat obstruction, not histology. With that said, we choose to maintain the use of BPH alongside BPO to remind us of the origin of our efforts, to be used as an mnemonic for our crusade, and to recognize its etched place in our vernacular:
The MANifesto is derived from a review of the AUA, EAU and NICE Guidelines as well as a contemporary MEDLINE search of the English-language literature. Search terms include but are not limited to BPH, BPO, BOO, urodynamics, pressure-flow study, IPSS, post-void residual, uroflowmetry, screening, bladder, detrusor. When multiple contrasting viewpoints are present, the ManVsProstate Medical Advisory Committee has offered an opinion based on the most applicable and contemporary data.?
The avatar for this MANifesto is the modern man of more than 44 years of age who presents with LUTS where BPH BPO is the major contributing factor. We fully recognize the multifactorial nature of LUTS and the need for ruling out concomitant diagnoses that may be primary or secondary causes of LUTS. In the spirit of Diversity, Equity & Inclusion, not all patients will identify as "male." This MANifesto applies to all patients with a prostate consistent with cis-male genitourinary anatomy whose bladders may be at-risk for death and dysfunction due to BPO (referred herein as "man" or "men").?
The term "urologist(s)" recognizes the united effort of deobstructing urologists (MD|DO) with the supporting clinical personnel that is required to provide care that is Personalized, Effective, Efficient, Simple and Safe. Appreciation is expressed for "team" members that include but are not limited to the following: advanced practice providers (NP, PA), clinical staff (MA, RN, pressure-flow technical specialists), administrative staff, C-suite executives, and Med Tech device healthcare industry representatives & managers.
Empowering bladders in the BPH fight against prostates | #WhatAboutMyBladder | Futurist | Street Busker | Author
1 年Thank you all for the feedback that is rolling in. 1. Addressing the needs of primary care physicians 2. Detailing specifics of cystoscopy regarding morphology: openness of the bladder outlet and the openness of the Supra collicular prostatic urethra. 3. Counseling in regards to irritative and obstructive sub score. 4. The benefits of using a cutoff for the PVR of 50cc versus 100 cc. 5. The pros and cons of screening starting at the age of 50 versus 60. 6. Adding a level of complexity when we discuss the urolow pattern. 7. Keep it simple stupid (KISS) 8. Primary care to do PVR repeated times. If the technology is available Sonny Schelin TAREQ ALSAODY Bilal Chughtai Austen Slade, MD, MBA
Medico Chirurgo, specialista in urologia e andrologia | Esperto in tecniche mini invasive | Editore di “Prostate Cancer Prostatic Diseases” | Sostenitore della campagna ManVsProstate
1 年I think that this MANifesto mirrors my vision, my mission, my way to do my job. Good diagnosis, preventative attitude, great respect for patients expectations! Together to increase patient’s education!