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.