LUTS Flashcards
What are voiding symptoms?
Intermittent Poor stream Hesitancy Terminal dribbling Incomplete emptying
What are storage symptoms?
Frequency
Urgency
Incontinence
What is the difference between nocturia and nocturnal polyuria?
Nocturia - increased frequency of urination during night
Nocturnal polyuria - increased volume of urine during night, causes nocturia
What are the causes of voiding symptoms?
BPH Anti-muscarinics - TCAs, sedating antihistamines Diabetic neuropathy Urethral strictures, phimosis Cancer
What are causes of over active bladder?
BPH Neuro - dementia, DM neuropathy, MS, Parkinsons, stroke Lower UTI, STI, prostatitis Bladder stones Cancer
What are causes of stress incontinence?
prostatectomy
injury to urethra
alcohol, caffeine, diuretics, alpha blockers
MS
Benzos, z drugs - pt unaware of need to go
What are causes of acute urinary retention?
obstruction - BPH Stones, blood clot Urethral stricture Severe constipation Pelvic tumour Perineal pain
What drugs can cause acute urinary retention?
Antimuscarinics - oxybutynin, tolterodine, TCAs, sedative antihistamines,
Anaesthesia
Opioids
Ephedrie
How woUld u examine a pt with LUTS?
- Abdo exam
- Genitals
- DRE
- Neurovascular
What investigations would you do for pt w LUTS?
Urinary frequency volume chart IPSS uRINE DIPSTICK Creatinine eGFR PSA
When would u delay a PSA?
Ejaculation in past 48hrs
Vigorous exercise in past 48hrs
Prostate biopsy in past 6 weeks
What is conservative treatment for OAB?
Bladder training
Lifestyle
Containment products
What is conservative treatment of stress incontinence due to prostatectomy
Pelvic floor muscle training for 3 months
What is conservative rx of voiding sx?
intermittent self catheterisation
then indwelling catheter
What is 1st line pharmacological rx of of LUTS?
alpha blocker - alfuzosin, tamsulosin