LUTS

Question 1

oBSTRUCTIVE voiding sx.

Answer 1

Hesitancy

Weak urine stream (stranguria)

Interrupted stream (intermittency)

Feeling of incomplete voiding

Post micturition dribbling

Question 2

Irritative voiding sx.

Answer 2

Frequency

Nocturia

Urgency

Urge incontinence

Dysuria

Question 3

Complications of bladder outflow obstruction

Answer 3

Chronic renal failure

Infection (Pyelonephritis, cystitis, epidydimitis)

Bladder calculus

Urinary retention(acute/chronic)

Bladder diverticulum

Question 4

Causes of obstructive voiding sx. women

Answer 4

Urethral obstruction

• urethral diverticulum
• Urethral CA
• Urethral stricture

bladder prolapse (cystocele)

Question 5

Causes of obstructive voiding sx MALES

Answer 5

uRETHRAL stricture

Bladder neck contracture (primary post-prostatectomy)

Prostatic enlargement (BPH or CA)

Question 6

Causes of irritative voiding sx.

Answer 6

Bladder inflammation (UTI, irradiation, CIS bladder)

Bladder outlfow obs

Detrusor instability

Neuropathic bladder

Small bladder capacity (TB, Interstitial cystitis)

Neighbourhood conditions (PID)

Question 7

Assessment of LUTS

Answer 7

Abdomen

Male external genitalia

Rectal examination

pelvic Exam women

Dipstick (Blood, PUS)

Labs( serum Cr and PSA), urine culture

Abd U/S (kidneys, bladder, prostate

retrograde urethrogram

prostate biopsy