Lower urinary tract symptoms

Lower urinary tract symptoms (LUTS) refers to symptoms related to the act of urination. They include voiding symptoms and storage symptoms. LUTS are classically caused by benign prostatic hyperplasia. Treatment of the underlying cause alleviates the symptoms.

Etiology

• BPH (most common)
• Lower urinary tract infection

Clinical features

We distinguish two types of LUTS, voiding symptoms (also called obstructive symptoms), and storage symptoms (also called irritative symptoms).

• Storage/irritative symptoms – symptoms related to abnormal bladder function
  • Urinary frequency – more than 8x a day
  • Urinary urgency – strong feeling of needing to void
  • Nocturia = the need to wake up multiple times in the night to urinate
    • Heart failure
  • Urinary incontinence
• Voiding/obstructive symptoms – symptoms related to abnormal voiding
  • Hesitancy – delayed initiation of micturition
  • Need for straining to urinate – patient must contract abdominal muscle to urinate
  • Intermittent, not continuous, urine stream
  • Terminal dribbling of urine
  • Sensation of incomplete voiding