Male LUTS

Question 1

The following are symptoms associated with __________?
Hesitancy
Poor or intermittent stream
Straining
Incomplete emptying
Terminal dribbling

Answer 1

Voiding

Question 2

The following are symptoms associated with ____?
Urgency
Frequency
Nocturia
Urinary incontinence

Answer 2

Storage

Question 3

What LUTS can occur following micturation?

Answer 3

Post-micturition dribbling
Sensation of incomplete emptying

Question 4

What examination is important to perform on males with LUTS?

Answer 4

PR examination to examine Prostate

Question 5

Investigations useful in patients with LUTS

Answer 5

urinalysis
PSA
Urine frequency-volume chart
IPSS score

Question 6

Management of predominantly voiding symptoms

Answer 6

Conservative
- pelvic floor muscle training
- bladder training

Mod/severe symptoms
- alpha-blocker

Enlarged prostate and high progression risk:
- 5-alpha reductase inhibitor

Not responding to an alpha blocker:
- antimuscarinic (anticholinergic)

Question 7

Management of predominantly storage symptoms

Answer 7

conservative:
- reduce fluid intake
- bladder retraining
- antimuscarinic drugs (oxybutynin, tolterodine)
- Mirabegron if 1st line drugs fail

Question 8

Management of nocturia

Answer 8

• reduce fluid intake at night
• furosemide 40mg in late afternoon
• desmopressin