Lower Urinary Tract Symptoms (LUTS)
Lower urinary tract symptoms (LUTS) are quite prevalent in adult men and cause significant symptoms and quality of life issues. The causes in both genders differ and it is a common misconception that they are only related to the prostate gland. Women also suffer with LUTS, but do not have a prostate gland.
LUTS can be divided into two main groups – storage and voiding.
The etiology can be quite complex and often there can be multiple factors contributing to patient symptoms at the same time.
Cause for LUTS include: benign prostatic enlargement (men only), leading to bladder outlet obstruction; bladder overactivity; bladder underactivity; neurogenic causes; bladder neck obstruction or dysfunction; urethral strictures; infections; foreign bodies; stones; tumours; medical conditions – cardiac, renal, liver disease, diabetes, pituitary pathology.
Given the potential complexity of LUTS these need careful evaluation with history, examination, urinalysis, renal function, questionnaires, bladder diaries, PSA, imaging studies, flow studies, videourodynamics, cystoscopy.
As one can appreciate LUTS has quite a complex group of symptoms and therefore the management can differ depending on what is considered to be the main cause in each patient.
The main approaches in the management of LUTS include:
- Conservative management/Watchful waiting
- Behavioral modification
- Dietary modification
- Lifestyle modification
- Pharmacological treatment – different classes of medications exist to target specific receptors on the prostate, bladder neck or bladder muscle itself aiming to relieve symptoms.
- Surgical treatment – a whole variety of surgical procedures and different technologies are used to treat patients with LUTS. They all have slightly different indications, success rate and side effect profile.
If you suffer with LUTS, Dr Penkoff will be more than happy to assess you, discuss with you the treatment options and help you choose one that best suits you.