Lower urinary tract symptoms (LUTS) refers to a constellation of symptoms originating in the bladder.
Terminology
Lower urinary tract symptoms are now subdivided into three discrete groups 2:
-
storage LUTS
- high daytime frequency, nocturia, urgency +/- related incontinence, altered bladder sensation
-
voiding LUTS
- hesitancy
- suboptimal urinary stream
- slow stream, even with effort
- intermittent
- splitting/spraying
- straining to pass urine
- terminal dribbling (at the end of the urinary stream)
-
postmicturition LUTS
- incomplete bladder emptying
- postmicturition dribble
It is important to decide into which group a patient's symptoms predominantly lie as it has an important bearing on their management 2.
Pathology
Aetiology
Although lower urinary tract symptoms are most frequently encountered in men with benign prostatic hypertrophy (BPH), they are also found in older women 1. As such, causes include 1:
- benign prostatic hypertrophy (BPH)
- bladder instability*
- decreased bladder compliance and capacity*
- urethral stricture*
- bladder neck contracture*
*apply to women too
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