Lower Urinary Tract Sumptoms (LUTS)
Lower urinary tract symptoms (LUTS)
Lower urinary tract symptoms (LUTS) are a group of symptoms which relate to problems with storing and passing urine. They may be caused by problems with the bladder, prostate, and urethra.
In men, LUTS is often caused by enlargement of the prostate. When the prostate grows larger than normal, it can constrict the urethra and lead to trouble with urination.
Dr. Tony Makris is responsible for managing LUTS at Paradigm Urology. As an experienced urologist, he provides both surgical and conservative medical care.
How is LUTS diagnosed?
IPSS
Your GP will usually grade your symptoms using the International Prostate Symptom Score (IPSS). This test assesses how your symptoms are impacting your life and helps determine how urgently you should see a specialist. You will be asked a series of questions about your symptoms and asked to rate how much they affect you on a scale of 1 to 5. You can read through the questions here.
Urinalysis
Your GP will often also ask for a urinalysis. This can help diagnose infections in the bladder and urethra. It can also help to identify bladder stones, diabetes, and other underlying issues which may cause LUTS.
Prostate ultrasound
A prostate ultrasound may be used to measure the size of your prostate. This can help determine if your symptoms are being caused by benign prostate hyperplasia (BPH). It may be combined with a prostate-specific androgen (PSA) blood test to check for elevated levels which may indicate prostate cancer.
Urodynamics studies
A specialist urologist can perform urodynamics studies – these assess the flow rate of urine, your bladder capacity, and the pressure of the bladder (detrusor) muscle. Dr Makris holds a subspecialty in this area.
How is LUTS treated?
The goal of LUTS treatment is to reduce or eliminate the impact that symptoms have on your day-to-day life. Dr Makris assesses the underlying cause and the impact of your symptoms to determine a suitable treatment. Treatments may include:
Lifestyle changes
your doctor may recommend smoking cessation, reducing alcohol and caffeine, or weight loss to help reduce symptoms.
'Watch and wait'
if LUTS aren’t causing significant impact to your day-to-day life, treatment may decrease your quality of life without providing significant benefit. You may be asked to monitor your symptoms at home and return to a urologist if they worsen.
Medications
These may help improve urine flow by relaxing the muscles in the bladder or prostate. If LUTS is caused by an infection, antibiotics may be prescribed to help eliminate it.
Intermittent catheterisation
This involves inserting a catheter through the urethra which allows you to manually drain your bladder. You will usually need to do this a few times a day, and your urologist will train you on how to do it on your own.
Transurethral resection of the prostate (TURP)
Also known as a ‘rebore’, this surgery cores away part of the prostate with a specialised tool called a resectoscope. Removing part of the prostate reduces the restriction it places on the urethra, which can make it easier to urinate.
LUTS Procedures
Paradigm Urology offers a range of procedures including:
- Transurethral resection of prostate (TURP)
- Bladder neck incision (BNI)
- Urethrotomy
- Intravesical botox