This is general health information only and is not a substitute for advice from your GP or healthcare professional.
1. What are lower urinary tract symptoms (LUTS)?
Lower urinary tract symptoms are urinary problems involving the bladder and urethra. They are commonly divided into storage symptoms, such as urinary frequency, urgency and nocturia, and voiding symptoms, such as a weak stream, hesitancy, straining and difficulty emptying the bladder.
2. What causes LUTS?
LUTS can have many causes. In men, benign prostatic enlargement is a common cause of voiding symptoms, but bladder overactivity, urinary tract infection, urethral narrowing, neurological conditions, medications and other bladder or prostate problems can also contribute. In women, bladder overactivity, urinary tract infections, pelvic floor dysfunction and genitourinary changes associated with menopause are common causes.
3. What are the common symptoms of LUTS?
Symptoms may include urinary frequency, urgency, nocturia, urinary leakage, a weak or interrupted stream, difficulty starting urination, straining, dribbling after urination, or a sensation that the bladder has not completely emptied.
4. Is LUTS the same as an enlarged prostate?
No. LUTS is a description of urinary symptoms rather than a specific diagnosis. An enlarged prostate can cause LUTS, particularly in men, but urinary symptoms do not necessarily mean that the prostate is enlarged. Other bladder or urinary conditions can produce similar symptoms.
5. How are LUTS diagnosed?
Assessment usually includes a medical history, medication review and physical examination. A urine test may be performed to exclude infection or blood in the urine. Depending on the symptoms, your doctor may also recommend a bladder diary, prostate assessment, blood tests such as PSA, or tests to measure urinary flow and bladder emptying.
6. Can lifestyle changes improve LUTS?
Yes. Depending on the underlying cause, reducing excessive fluid intake, limiting caffeine and alcohol, avoiding large amounts of fluid before bedtime, maintaining a healthy weight, treating constipation and practising appropriate bladder training can improve symptoms.
7. What treatments are available for LUTS?
Treatment depends on the cause and severity of symptoms. Options may include lifestyle measures, pelvic floor therapy, medicines that relax the prostate or bladder, or treatment of an underlying condition. For men with bothersome symptoms caused by benign prostate enlargement, medicines such as alpha-blockers or 5-alpha-reductase inhibitors may be considered.
8. Can LUTS be a sign of prostate cancer?
LUTS is not usually caused by prostate cancer, and most men with urinary symptoms do not have prostate cancer. However, prostate cancer can sometimes occur without symptoms, so appropriate prostate assessment should be considered according to age, risk factors and individual circumstances.
9. When should I see a doctor about LUTS?
You should see a doctor if urinary symptoms are persistent, worsening, or interfering with sleep or daily activities. Assessment is particularly important if you notice blood in the urine, recurrent urinary infections, significant difficulty emptying the bladder, or unexplained weight loss.
10. When are LUTS an emergency?
Sudden inability to pass urine despite a strong urge to urinate requires urgent medical assessment because acute urinary retention can damage the bladder and kidneys. Urgent assessment is also required for severe urinary symptoms accompanied by fever, chills, severe pain, vomiting, or significant blood in the urine.