Lower Urinary Tract Symptoms in Men

Doctors Lisa and Sara talk with Consultant Urologist Dan Burke about Lower Urinary Tract Symptoms in Men. We start with how to divide symptoms into voiding and storage. Red flags to consider are discussed, before tackling cases that lead us to talk about bladder diaries, tips for assessing the prostate and how PSA discussions have changed since the introduction of MRI scans and transperineal prostate biopsies. In discussing the thorny subject of prostate cancer and best treatment choices for individuals, we talk about radical treatment, advanced disease and the difference between watchful waiting and active surveillance. Though we talk about men, it is well worth mentioning these symptoms will apply to all people with a prostate including trans women and some non-binary people.

Useful resources: 

• NICE Clinical Knowledge Summaries (Updated March 2019): https://cks.nice.org.uk/topics/luts-in-men/

• Guidelines in Practice (2014): Full assessment is key for men with lower urinary tract symptoms: https://www.guidelinesinpractice.co.uk/mens-health/full-assessment-is-key-for-men-with-lower-urinary-tract-symptoms/341437.article

• Urinary Frequency Charts to assess bladder volume, polyuria and nocturia: https://bladdermatters.co.uk/downloads/85923fchart.pdf

• LUTS in Men Tower Hamlets NHS guidelines (2012) includes patient information sheets: https://www.qmul.ac.uk/blizard/ceg/media/blizard/images/documents/Lower-Urinary-Tract-Symptoms-in-Men,-Care-Pathway,-January-2012.pdf

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This podcast has been made with the support of Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

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