Lower Urinary Tract Symptoms (LUTS) are a common problem for Australian men with an incidence that increases with age.
In fact 48 per cent of men aged 65-79 and 70 per cent of men in their 80s will experience LUTS. The most common cause of these symptoms is Benign Prostatic Hyperplasia (BPH).
Campbelltown Private Hospital urologist Dr Pascal Mancuso said the International Prostate Symptom Score (IPSS) is used to assess the extent of the problem and which symptoms are predominant.
A full medical history is also taken to identify symptoms such as nocturia (night waking to urinate) which can arise due to medical conditions such as Obstructive Sleep Apnoea, Congestive Cardiac Failure or Diabetes as well as a smoking history which can predispose the bladder to irritative LUTS.
"A general physical examination from a specialist urologist will help exclude medical causes of LUTS, as well as an abdominal examination to exclude a palpable bladder," Dr Mancuso said.
"A urologist might also advise a test to assess for the risk of Prostate Cancer."
Dr Mancuso said Alpha Blockers are the mainstay of medical treatment.
"This releases the capsule of the prostate and improves symptoms. However, they do have side effects which need to be considered and should be discussed with your doctor."
Alpha Reductase Inhibitors can be used alone or in combination with an Alpha Blocker and alter testosterone metabolism. Over a period of six months this will cause prostate shrinkage.
Dr Mancuso said If medical options don't alleviate symptoms, some patients will require surgical intervention.
"Previously the gold standard surgical treatments for BPH was transurethral resection of the prostate (TURP) which was quite invasive. However, there have been multiple advancements in many less invasive surgical treatment options."
These can include Diode Laser Prostatectomy, a Urolift, Rezum Steam Treatment or Robotic Simple Prostatectomy which is reserved for patients with a Prostate Volume of at least 150g which makes endoscopic techniques less successful.
If you have been experiencing LUTS you can arrange for a referral to a specialist urologist. They will be able to discuss your symptoms and concerns and recommend a suitable treatment that addresses your individual needs.
Dr Mancuso is a urologist with Macarthur Urology and has a special interest in male voiding dysfunction and BPH. He provides consulting services at Suite 120/4 Hyde Parade, Campbelltown. If you would like to arrange for a consultation with Dr Mancuso speak with your GP first.