This guideline covers managing lower urinary tract symptoms (LUTS) in men over 18. It aims to improve the quality of life for men with LUTS by recommending which assessments they should receive, and when conservative management, drug treatment and surgery can help.
Lower urinary tract symptoms (LUTS) comprise storage, voiding and post‑micturition symptoms affecting the lower urinary tract. There are many possible causes of LUTS such as abnormalities or abnormal function of the prostate, urethra, bladder or sphincters. In men, the most common cause is benign prostate enlargement (BPE), which obstructs the bladder outlet. BPE happens when the number of cells in the prostate increases, a condition called benign prostatic hyperplasia.
Other conditions that can cause LUTS include detrusor muscle weakness or overactivity, prostate inflammation (prostatitis), urinary tract infection, prostate cancer and neurological disease. This clinical guideline will advise on the effective evidence‑based management of LUTS in men.
LUTS in men are best categorised into voiding, storage or post‑micturition symptoms to help define the source of the problem.
LUTS in men are best categorised into voiding, storage or post‑micturition symptoms to help define the source of the problem. Voiding symptoms include weak or intermittent urinary stream, straining, hesitancy, terminal dribbling and incomplete emptying. Storage symptoms include urgency, frequency, urgency incontinence and nocturia. The major post‑micturition symptom is post‑micturition dribbling, which is common and bothersome. Although LUTS do not usually cause severe illness, they can considerably reduce men's quality of life, and may point to serious pathology of the urogenital tract.
LUTS are a major burden for the ageing male population. Age is an important risk factor for LUTS and the prevalence of LUTS increases as men get older. Bothersome LUTS can occur in up to 30% of men older than 65 years. This is a large group potentially requiring treatment.
You can read the guideline on NICE's website.