Douglas F. Milam M.D.

Urologic Surgery

  • Home
  • About Us
  • Surgical ProceduresClick to open the Surgical Procedures menu
    • Urethral Stricture Repair
    • Surgical Procedures to Improve Continence in Men
    • Penile Implant
    • Surgical Treatment of Peyronie's Disease
  • Evaluation of Voiding DysfunctionClick to open the Evaluation of Voiding Dysfunction menu
    • Incontinence in Men
    • Urinary Retention
    • Severe Lower Urinary Tract Symptoms
    • Urinary Frequency, Urgency, and Urge Incontinence
    • Urodynamic Testing
    • Cystoscopy
  • Patient InformationClick to open the Patient Information menu
    • IPSS-AUA Symptom Score
    • Sexual Function Questionnaire
    • Deactivate a Urinary Sphincter
    • VPEC
    • Overnight Surgical Stay
    • Post-operative Instructions Urethral Stricture Repair
    • Post-operative Instructions Penile Implant
    • Post-operative Instructions Artificial Urinary Sphincter
    • Post-operative Instructions Placement of Male Sling
    • Post-operative Instructions Penile Curvature Repair
    • Post-procedure Instructions Vasectomy
    • Mechanism of Erection
    • Statement on Urologic Pain
  • Schedule a Consultation
  • DirectionsClick to open the Directions menu
    • Vanderbilt Clinic Location
    • Cool Springs Location
    • Main Operating Rooms
  • Urologic Images
  • Web References

Severe Lower Urinary Tract Symptoms

Lower Urinary Tract Symptoms, or LUTS, are bothersome urinary symptoms which may be caused by bladder outlet obstruction due to prostate growth, primary bladder neck obstruction,  urethral stricture disease, bladder overactivity or underactivity, bladder neck contracture, radiation cystitis, or neurologic conditions that affect bladder or bladder outlet function.  By definition, the severity of LUTS depends on the severity of patient symptoms.  Our first step is to assess symptoms with a validated patient questionnaire.  We administer both the urinary symptom questionnaire and the sexual function questionnaire in this setting.  Several recent studies have demonstrated an association with LUTS and decreased sexual function. We will also take a history and perform a physical exam in addition to reviewing the validated patient questionnaires. Many patients are given an emperic course of medication based on their symptoms.  These can be either medications to relax the bladder outlet (alpha blockers), shrink the prostate (5-alpha reductase inhibitors), or medications to quiet the bladder.  

Many patients referred to our practice have tried and failed multiple medications before being seen here.  In that case, urodynamic testing and cystoscopy is often indicated to identify the specific location of the problem and guide further treatment.

Copyright 2010-2015  Milam Urology. All rights reserved.