Lower urinary tract symptoms

Question 1

What can cause lower urinary tract symptoms in men?

Answer 1

BPH
UTI
Urological malignancy
Detrusor weakness or instability
Chronic prostatitis
Uretral stricture
External compression - e.g. pelvic malignancy
Neurological causes - e.g. spinal cord injury

Question 2

What can cause lower urinary tract symptoms in women?

Answer 2

UTI
Menopause
Urological malignancy
Detrusor weakness or instability
Urethral stricture
External compression
Neurological diseases

Question 3

What lifestyle factors can exacerbate lower urinary tract symptoms?

Answer 3

Drinking fluids late at night
Excess alcohol
Excess caffeine

Question 4

What are the storage lower urinary tract symptoms?

Answer 4

Urgency
Increased frequency
Nocturia
Urinary incontinence

Question 5

What are the voiding lower urinary tract symptoms?

Answer 5

Hesitancy
Intermittency / poor stream
Straining
Terminal dribbling
Incomplete emptying

Question 6

What other symptoms should be asked about when someone presents with lower urinary tract symptoms?

Answer 6

Visible haematuria
Suprapubic discomfort
Any pain / burning when passing urine
Any colicky pain (loin to groin)

Question 7

What investigations can be done for lower urinary tract symptoms?

Answer 7

Urinalysis - dipstick and culture
Blood tests - FBCs, U+Es and PSA
Post void bladder scanning + flow rate
Urodynamic studies 
Cystoscopy
Upper urinary tract imaging

Question 8

What will post void bladder scanning + flow rate show in BPH?

Answer 8

High post void residual volume

Low flow rate

Question 9

What will post void bladder scanning + flow rate show in overactive bladder?

Answer 9

Low post-void residual volume

Question 10

How are lower urinary tract symptoms managed conservatively?

Answer 10

Treatment of underlying pathology!!!!
Regulate fluid intake - reduce caffeine + alcohol as well as fluid intake before bed.
Pelvic floor exercises or bladder training techniques may be useful