Lower urinary tract symptoms (or LUTS) are very common in men as they get older.
The Prostate is just below the bladder around the upper part of the urethra. As men get older, their prostates get bigger. This can block the flow of urine and cause urinary obstruction.
Lower urinary tract symptoms (or LUTS) include difficulty starting, slowing of the urinary stream with interrupted flow and incomplete bladder emptying. The bladder may become overactive (OAB) with frequent urination, urgency and nocturia. Urinary incontinence may occur.
Prostate enlargement (or BPH) usually begins in the 40's, but symptoms usually start in the 50's or 60's. Prostate cancer can also cause symptoms of obstruction, but this is less common.
Assessment of Urinary Symptoms
- Prostate cancer risk assessment (PSA, DRE)
- Severity of symptoms using a symptom score (IPSS) and urinary flow rate
- Complications of prostate obstruction (urinary retention, infection, stones, kidney problems)
► Observation - if your symptoms are mild or moderate and do not bother you, you probably don't need treatment! We will need to do some tests to ensure that it is safe to observe your symptoms, and you will have follow-up with your GP or Mr Lindsay.
► Bladder overactivity - if your bladder is overactive, bladder retraining and/or medication can increase your functional bladder capacity. The aim is to reduce symptoms of urinary frequency, urgency and urge incontinence
► Medication for obstruction - can improve urinary flow by relaxing the muscle in the bladder neck and prostate, and also by reducing the size of the prostate. Medication is usually the first treatment option for men with mild to moderate symptoms.
► Prostate surgery - a TURP or "rebore" is done in men with severe, bothersome symptoms. It may also be needed for men with complications of obstruction (infection, bladder stones, kidney problems) or if there is a complete blockage (acute retention).