What are lower urinary tract symptoms?
Lower urinary tract symptoms — often shortened to LUTS — are changes in how you store or pass urine. They become more common with age and can have several causes, including an enlarged prostate, an overactive bladder, infection or, less often, something more serious.
Because the causes vary, choosing the right treatment depends on careful assessment, appropriate investigations, and expert interpretation of the findings.
Symptoms
Symptoms are usually grouped into two types:
- Storage symptoms - Daytime or nocturnal frequency, urgency, or leakage.
- Voiding symptoms - Hesitancy, weak or slow stream, or incomplete emptying.
How symptoms are assessed
We will review your symptoms (sometimes using a simple bladder score (IPSS) and bladder diary), test your urine, measure your urine flow and check how well your bladder empties. A PSA test and digital rectal examination (DRE) may be performed where appropriate, along with a flexible cystoscopy (camera inspection of the urethra and bladder), and occasionally formal urodynamics (bladder pressure/flow studies).
Treatment
Treatment will depend on the underlying cause of your symptoms. In many cases, simple measures such as lifestyle changes, reducing bladder irritants and bladder training are all that is needed. Other people may benefit from medication, while some require a minimally invasive procedure or surgery.
The first step is to identify the cause of your symptoms through a careful assessment and, where appropriate, further investigations. Once a diagnosis has been made, a personalised treatment plan can be recommended. Most people experience a significant improvement in their symptoms and quality of life with the right treatment.