Fast Five Quiz: Lower Urinary Tract Symptoms (LUTS)

Bradley Schwartz, DO

Disclosures

July 20, 2022

Clinical manifestations of LUTS related to BPH include urinary frequency, urgency, nocturia (awakening at night to urinate), decreased or intermittent force of stream, or a sensation of incomplete emptying. Complications occur less commonly but may include acute urinary retention, impaired bladder emptying, the need for corrective surgery, renal failure, recurrent UTIs, bladder stones, or gross hematuria.

BPH is a common problem that affects the quality of life through the development of LUTS in approximately one third of men older than 50 years. The prevalence may be as high as 50%-60% for men in their 60s and as high as 80%-90% for those older than 70 years.

The prevalence of BPH in White men and Black men is similar. However, BPH tends to produce more severe LUTS and to be more progressive in Black men, possibly because of the higher testosterone levels, 5-alpha reductase activity, androgen receptor expression, and growth factor activity in this population. The increased activity leads to an increased rate of prostatic hyperplasia and subsequent enlargement and its sequelae.

Patients should be informed that the following lifestyle changes may help relieve LUTS:

  • Avoid alcohol and caffeine

  • Avoid drinking fluids at bedtime, and drink smaller amounts throughout the day

  • Avoid taking decongestant and antihistamine medications

  • Get regular exercise

  • Make a habit of going to the bathroom when the urge is present

  • Practice double voiding (empty the bladder, wait a moment, then try again)

  • Practice stress management and relaxation techniques

Learn more about LUTS related to BPH.

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