Is There Evidence of Diagnostic and Treatment Gaps for LUTS in Post-Menopausal Women With Genitourinary Syndrome of the Menopause? ICI-RS 2025
Apostolidis, Apostolos Da Silva, Ana Sofia Gray, Thomas Khullar, Vik Mohamed-Ahmed, Rayan Papaefstathiou, Efstathios Van den Ende, Mauro Wein, Alan Abrams, Paul Robinson, Dudley
Apostolidis, Apostolos
Da Silva, Ana Sofia
Gray, Thomas
Khullar, Vik
Mohamed-Ahmed, Rayan
Papaefstathiou, Efstathios
Van den Ende, Mauro
Wein, Alan
Abrams, Paul
Robinson, Dudley
Affiliation
Aristotle University of Thessaloniki; King's College Hospital; Norfolk and Norwich University Hospitals NHS Foundation Trust; The Dudley Group NHS Foundation Trust
Other Contributors
Publication date
2025-11-26
Subject
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
AIMS: This report, from the International Consultation on Incontinence-Research Society, aims to evaluate the existing evidence and identify diagnostic and treatment gaps for Lower Urinary Tract Symptoms (LUTS) in post-menopausal women with Genitourinary Syndrome of Menopause (GSM).
METHODS: An overview on the current literature, including pathophysiology, diagnosis and management of GSM associated LUTS, including incontinence, overactive bladder, underactive bladder and recurrent urinary tract infections (rUTIs).
RESULTS: Significant gaps in the literature were identified. GSM is underdiagnosed and the interplay between hormonal changes in the postmenopausal period on LUTS remains poorly understood. Diagnostic methods for rUTIs lack sensitivity and the role of the urinary microbiome is emerging. Current treatments, including topical oestrogens and systemic hormone therapy, lack long-term efficacy data on LUTS. Evidence for regenerative medicine techniques remain limited by low-quality studies and short-term follow up.
CONCLUSION: There is lack of high-quality evidence, which hinders the optimal management of LUTS in post-menopausal women with GSM. The panel proposes targeted research questions, focusing on the hormonal impact on the lower urinary tract, advancing diagnostics and robust clinical trials for existing and novel therapies, to bridge current gaps in the literature and improve patient care.
Citation
Apostolidis A, Da Silva AS, Gray T, Khullar V, Mohamed-Ahmed R, Papaefstathiou E, Van den Ende M, Wein A, Abrams P, Robinson D. Is There Evidence of Diagnostic and Treatment Gaps for LUTS in Post-Menopausal Women With Genitourinary Syndrome of the Menopause? ICI-RS 2025. Neurourol Urodyn. 2025 Nov 26. doi: 10.1002/nau.70173
Type
Article