Lower Urinary Tract Symptoms (LUTS)

Last updated 23.02.13

 

Index

 

Definition

-  Urinary voiding or storage symptoms in men

-  Voiding symptoms

-   Hesitancy

-   Poor urinary stream

-   Intermittent flow

-   Incomplete emptying

-   Postvoid dribbling

-   Overflow incontinence

-  Storage symptoms

-   Frequency

-   Nocturia

-   Urgency

-  Urge incontinence

 

Features

-  Common in men

-  Incidence increases with age

 

Causes

-  Voiding S/S

-  BPH

-  Prostate Ca

-  Bladder neck stenosis

-  Urethral stricture

-  Poor detrusor contractility

-  Storage S/S

-  BPH

-  Prostate Ca

-  UTI

-  Bladder calculi

-  Urothelial carcinoma

-  Overactive bladder

 

Associated S/S

-  Haematuria

-  Recurrent UTI

-  Urinary retention

-  Palpable bladder

-  Anuria

 

Ix

-  DRE (PR)

-  Size: BPH

-  Shape, tecxture, nodules: prostate Ca

-  Urine dipstick + MCS

-  UTI

-  Haematuria

-  +/- urethral cytology to exclude urothelial carcinoma

-  US

-  TA: prostate size usually inaccurate

-  TRUS: most accurate

-  PSA

-  +/- Post void residual volumes

-  +/- Uroflowmetry

 

Mx

-  Further Ix & refer early all pts with

-  Urinary retention

-  Haematuria

-  Recurrent UTIs

-  Bladder stones

-  Urgency or flow incontinence

-  As per cause

 

 

 

References

 

AFP, Vol 40, No 10, October 2011: BPH Management in General Practice,  Arianayagam et al

http://www.racgp.org.au/download/documents/AFP/2011/October/201110arianayagam.pdf