initial specialist assessment of lower urinary tract symptoms (LUTS) in men
Last reviewed 01/2018
Specialist assessment refers to assessment carried out in any setting by a healthcare professional with specific training in managing LUTS in men (1):
- assess general medical history to identify possible causes of LUTS, and
associated comorbidities. Review current medication, including herbal and
over-the-counter medicines to identify drugs that may be contributing to the
problem
- offer a physical examination guided by urological symptoms and other medical
conditions, an examination of the abdomen and external genitalia, and a digital
rectal examination (DRE)
- men with LUTS should be asked to complete a urinary frequency volume chart
- offer men with LUTS information, advice and time to decide if they wish
to have prostate specific antigen (PSA) testing if:
- their LUTS are suggestive of bladder outlet obstruction secondary to BPE or
- their prostate feels abnormal on DRE or
- they are concerned about prostate cancer
- offer men with LUTS measurement of flow rate and post void residual volume
- cystoscopy to men with LUTS having specialist assessment should on be offered
when clinically indicated, for example if there is a history of any of the
following:
- recurrent infection
- sterile pyuria
- haematuria
- profound symptoms
- pain
- imaging of the upper urinary tract to men with LUTS having specialist assessment
should only be offered when clinically indicated, for example if there is
a history of any of the following:
- chronic retention
- haematuria
- recurrent infection
- sterile pyuria
- profound symptoms
- pain
- multichannel cystometry should be considerd for men with LUTS having specialist
assessment if they are considering surgery
- pad tests to men with LUTS should only be offered if having specialist assessment if the degree of urinary incontinence needs to be measured
Reference:
initial non-specialist assessment of lower urinary tract symptoms (LUTS) in men