GPAtlas🧭 When to suspect
Lower urinary tract symptoms (LUTS) are extremely common in men and rise steeply with age.
• LUTS are not a diagnosis but a symptom complex with many causes.
• Most often the cause is benign prostatic enlargement.
• Other causes include overactive bladder, urinary tract infection (UTI), bladder or prostate cancer, neurological disease, and the effects of medication.
Two clinical steps anchor the assessment:
• First, sort the symptoms into three groups, because the pattern points to the likely mechanism and to the right treatment.
• Second, actively exclude the dangerous causes – retention, renal impairment and malignancy – which are easily missed in a man who simply reports a "weak stream".
| Symptom group | Typical symptoms | Often suggests |
|---|---|---|
| Storage | Urgency, daytime frequency, nocturia, urgency incontinence | Overactive bladder (OAB) |
| Voiding | Hesitancy, slow or intermittent stream, straining, terminal dribbling | Bladder outlet obstruction (e.g. benign prostatic hyperplasia, BPH) |
| Post-micturition | Post-micturition dribble, sensation of incomplete emptying | • Often follows obstruction • Usually benign |
Source: NICE CG97
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