Assessment of lower urinary tract symptoms

Publication date: Available online 16 May 2019Source: Surgery (Oxford)Author(s): Jay KhastgirAbstractLower urinary tract symptoms (LUTS) encompass a range of symptoms commonly experienced by both men and women, and encountered by a wide range of healthcare practitioners (HCPs). This review summarizes the basic terminology and assessment that HCPs should be aware of, regardless of their professional discipline. Apart from emphasizing the need for standardization in terminology, there is a need to avoid misleading terms that suggest a causative mechanism until the mechanism has been identified by investigation. HCPs should also avoid arbitrary thresholds for judging severity of symptoms. The use of algorithms from evidence-based guidelines limits variation in management and avoids unnecessary investigations. However, a tailored approach is useful in understanding the underlying pathophysiology in individual patients. As symptoms are unreliable in predicting the underlying mechanism, a useful approach is to try and develop a urodynamic diagnosis mindful of the normal physiology of the lower urinary tract as the practitioner works through the symptoms, signs and appropriate urodynamic investigations, and use such investigations in a logical manner tailored to the individual to either support or refute assumptions and arrive at a working diagnosis.

Source: Surgery (Oxford) - May 17, 2019 Category: Surgery Source Type: research