Primary Care Evaluation and Treatment of Men With Lower Urinary Tract Symptoms

Abstract

Lower urinary tract symptoms (LUTS) affect 50% to 90% of men aged 50 years or older. Primary care physicians should be knowledgeable about the diagnosis and management of this condition. The authors performed detailed PubMed searches using the terms lower urinary tract symptoms, benign prostatic hyperplasia, benign prostatic enlargement, and overactive bladder. The authors then reviewed the relevant literature on the evaluation and treatment of men with LUTS. According to the literature, accurate recognition of LUTS is predicated on a focused history and physical examination, as well as serum prostate-specific antigen measurement and urinalysis. For patients with mild symptoms, watchful waiting with ongoing monitoring and lifestyle modifications may be appropriate. For patients with moderate to severe symptoms, pharmacologic therapy is effective. When substantial LUTS persist despite appropriate pharmacologic therapy, specialty urologic evaluation and treatment is warranted.

Pelvic Floor Muscle Training for Urinary Incontinence After Radical Prostatectomy: A Narrative Review

“…Patient history should focus on lower urinary tract symptoms, previous surgical and radiotherapy history, family history of prostate disease (benign hypertrophy and cancer) and an overview of sexual and bowel habits. 16 Of paramount importance in RP-UI assessment is a description of the type and severity of incontinence and precipitating events. The number and severity of symptoms can be quantitatively evaluated by International Prostate Symptom Score.…”

Health‐related quality of life in patients undergoing TURP: Translating evidence into urological nursing practice

“…104 If in the assessment it is exposed that symptoms are minimally disrupting the patient's state, the "watchful waiting" method might be most appropriate. 106 Objective, as well as subjective symptom assessments, should be taken into consideration amid the full range of psychological states. 105 Intensive health education on lifestyle changes, reassurance, and ongoing monitoring ought to be part of the nursing care plan in patients at the "watchful waiting" stage.…”

“…105 Intensive health education on lifestyle changes, reassurance, and ongoing monitoring ought to be part of the nursing care plan in patients at the "watchful waiting" stage. 106 Objective, as well as subjective symptom assessments, should be taken into consideration amid the full range of psychological states. It is important to not only diagnose negative emotional states such as depression and anxiety, but also the positive components of one's experience, such as satisfaction, hope, and ease of adaptability.…”