Lower Urinary Tract Symptoms (LUTS)

Question 1

What are LUTS presented in men over 50 most likely to be caused by and from?

Answer 1

Benign Prostate Enlargement (Link to prostate cancer symptoms)

Question 2

What are the 3 main LUTs storage symptoms/issues?

Answer 2

1) Urgency
2) Frequency
3) Nocturia

Question 3

What are the 4 main LUTs voiding symptoms/issues?

Answer 3

1) Straining
2) Hesitancy
3) Incomplete emptying
4) Poor flow

Question 4

What could dysuria be an indication of?

Answer 4

Inflammation

Question 5

What investigations would you carry out for someone with LUTs symptoms?

Answer 5

1) Urine Test e.g. dipstick
2) Blood tests e.g. PSA, U&E
3) Urinary Flow: Max flow rate and residual volume
4) Symptom assessment: International prostate scoring system

Question 6

What is the main treatment method for mild LUTs symptoms?

Answer 6

Reassurance and active monitoring

Question 7

What are the 3 main causes of nocturnal polyuria?

Answer 7

1) Habitual
2) Congestive cardiac failure
3) Sleep apnoea

Question 8

What is the main treatment for moderate LUTs symptoms?

Answer 8

1) Fluid management e.g. avoid caffeine

2) Bladder drill

Question 9

What are the main pharmacological treatments for LUTs?

Answer 9

1) 5-alpha reductase inhibitors

2) Alpha-1 blockers e.g. Tamulosin

Question 10

How do alpha-1-blockers work in the management of LUTS?

Answer 10

• Cause vasodilation so reduced resistance and pressure to bladder outflow
  Tamulosin Side Effects: Hypotension and Retrogade Ejaculation

Question 11

How do 5-alpha reductase inhibitors work in treatment of LUTs?

Answer 11

Prostate size is reduced as inhibit conversion of testosterone to dihydrotestosterone

Question 12

How are BPE usually treated surgically?

Answer 12

TURPS

Transurethral resection of the prostate

Question 13

What are the main consequence of untreated LUTs?

Answer 13

1) Bladder calculi (Stones)
2) UTI
3) Urinary Incontinence
4) Acute urinary retention
5) Reduced quality of life