LUTS Flashcards

1
Q

What are voiding symptoms?

A
Intermittent 
Poor stream 
Hesitancy 
Terminal dribbling 
Incomplete emptying
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2
Q

What are storage symptoms?

A

Frequency
Urgency
Incontinence

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3
Q

What is the difference between nocturia and nocturnal polyuria?

A

Nocturia - increased frequency of urination during night

Nocturnal polyuria - increased volume of urine during night, causes nocturia

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4
Q

What are the causes of voiding symptoms?

A
BPH
Anti-muscarinics - TCAs, sedating antihistamines
Diabetic neuropathy
Urethral strictures, phimosis
Cancer
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5
Q

What are causes of over active bladder?

A
BPH
Neuro - dementia, DM neuropathy, MS, Parkinsons, stroke
Lower UTI, STI, prostatitis
Bladder stones
Cancer
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6
Q

What are causes of stress incontinence?

A

prostatectomy
injury to urethra
alcohol, caffeine, diuretics, alpha blockers
MS
Benzos, z drugs - pt unaware of need to go

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7
Q

What are causes of acute urinary retention?

A
obstruction - BPH
Stones, blood clot
Urethral stricture 
Severe constipation 
Pelvic tumour 
Perineal pain
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8
Q

What drugs can cause acute urinary retention?

A

Antimuscarinics - oxybutynin, tolterodine, TCAs, sedative antihistamines,
Anaesthesia
Opioids
Ephedrie

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9
Q

How woUld u examine a pt with LUTS?

A
  1. Abdo exam
  2. Genitals
  3. DRE
  4. Neurovascular
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10
Q

What investigations would you do for pt w LUTS?

A
Urinary frequency volume chart
IPSS
uRINE DIPSTICK 
Creatinine
eGFR
PSA
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11
Q

When would u delay a PSA?

A

Ejaculation in past 48hrs
Vigorous exercise in past 48hrs
Prostate biopsy in past 6 weeks

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12
Q

What is conservative treatment for OAB?

A

Bladder training
Lifestyle
Containment products

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13
Q

What is conservative treatment of stress incontinence due to prostatectomy

A

Pelvic floor muscle training for 3 months

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14
Q

What is conservative rx of voiding sx?

A

intermittent self catheterisation

then indwelling catheter

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15
Q

What is 1st line pharmacological rx of of LUTS?

A

alpha blocker - alfuzosin, tamsulosin

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16
Q

What is 1st line pharmacological rx of OAB?

A

Anticholinergic - oxybutynin

17
Q

What is pharmacological rx of prostate enlargement?q

A

5ARI - finasteride

Alpha blockers

18
Q

What is treatment of nocturnal polyuria?

A

loop diuretic in late afternoon
or
oral desmopressin

19
Q

wHAT IS surgical rx of LUTS?

A

TURP

Prostatectomy

20
Q

What is surgical treatment of storage problems?

A

cystoplasty

injections of botulinum toxinn

21
Q

What are causes of urethral strictures?

A

iatrogenic - catheter traumatic placement
STI
Hypospadias
Lichen sclerosus