Lower urinary tract symptoms in men: Causes, symptoms, and treatment

lower urinary tract symptomsThe term lower urinary tract symptoms (LUTS) refers to storage, voiding, and post-void dribbling. Not only do LUTS affect a man’s quality of life, but they can also signal a more serious health concern. Being able to spot these symptoms can help reduce the risk of any lower urinary tract complications.

Prevalence of LUTS

A study found that nearly half of adults over the age of 20 will experience at least one lower urinary tract symptom in 2018. Issues such as incontinence will increase as well, especially in South America, Asia, and developing areas of Africa.


Lead author of the study Dr. Debra E. Irwin said, “Our study suggests that urinary and bladder symptoms are already highly prevalent worldwide and that these rates will increase significantly as the population ages. These findings raise a number of important worldwide issues that will need to be tackled, as a matter of urgency, by clinicians and public health experts if we are to prevent, and manage, these conditions.”

The researchers used data from the U.S. Census Bureau International Data Base and the EPIC study, a large population-based, cross-sectional telephone survey of more than 19,000 men and women in five countries, led by Dr. Irwin.

Dr. Irwin explained, “It is well known that people do not always seek medical attention for urinary problems, so basing our figures on studies using self-reported symptoms is an effective way of measuring worldwide prevalence.”

Key findings of the study showed the worldwide prevalence of LUTS will increase to just under 46 percent in 2018. Between 2008 and 2018, the number of people who experience at least one LUTS increased 18 percent (affecting 2.3 billion people), overactive bladder increased 20 percent, urinary incontinence increased 22 percent, and LUTS and bladder outlet obstruction will rise 18.5 percent in 2018.

LUTS is the most common condition amongst older males. An estimated 30 percent of males of 50 suffer from LUTS with this number jumping to 40 percent of men over 75. Nocturia roughly affects around 69 percent of males over 85 compared to only 49 percent of women. The most common underlying cause of LUTS in men is benign prostatic hyperplasia (BPH).

Symptoms of LUTS

Symptoms arise as a result of problems with the lower urinary tract, including the bladder, prostate, and urethra. Symptoms can be categorized as either voiding symptoms or storage symptoms.

Voiding symptoms include:

  • Hesitancy to release urine
  • Weak and poorly directing stream of urine
  • Straining to urinate
  • Dribbling after urination
  • Chronic urinary retention
  • Overflow of urine

Storage symptoms include:

  • Strong urgency to urinate
  • Greater frequency when urinating
  • Nighttime urination – nocturia
  • Urge incontinence

If you’re a male over the age of 60 and are experiencing any of the above symptoms, you don’t have to suffer in silence. Speak to your doctor to uncover the underlying cause of your bladder problems and get on a treatment plan to help improve your bladder problems as well as the overall quality of your life.

Risk factors for lower urinary tract symptoms include (LUTS) increased serum dihydrotestosterone levels, obesity, elevated fasting glucose, diabetes, fat and red meat intake, and inflammation.

What Causes LUTS?

Enlarged prostate complicationsThe most common causes of LUTS include an enlarged prostate, overactive bladder, and water balance problems.

When the prostate grows in size, it can cause voiding problems, leaving men with a weak stream. This prevents them from completely emptying their bladder. This leads to frequent trips to the bathroom and a frequent urge to urinate.

It is more common among older men and women to develop an overactive bladder. Over time, the bladder’s ability to store urine becomes weaker and there is a stronger need to pass urine. If a person with an overactive bladder doesn’t reach a bathroom in time, there is a higher risk for bladder leaks.

Lastly, over time, the body’s ability to successfully pass the urine throughout the night also diminishes and so a person needs to urinate more often throughout the sleeping hours.

Other causes of LUTS include diabetes, urinary infections, bladder stones, prostate cancer, bladder cancer, and neurological conditions.

Lifestyle Changes for Managing Lower Urinary Tract Symptoms in Men

If symptoms are not bothersome or complicated, then your doctor may just monitor you and ask you to report any changes you notice. You will be asked to moderate your fluid intake (too much fluid can aggravate your symptoms) and reduce your intake of alcohol, caffeine, and sweeteners, as these can worsen infections.

Reduce your fluid intake prior to times when you won’t be able to get to a bathroom such as road trips or during movies. Stop smoking as smoking is a known bladder irritant. Train your bladder by trying to hold in your urine for longer periods of time.

If hesitancy is a problem, then put on some calming music or background noise to help you go.

If urgency is the problem, then try to distract yourself with breathing exercises or counting.

Other lifestyle changes include supervised pelvic floor muscle exercises by contracting your muscles to interrupt your stream and strengthen your pelvic floor muscles.

Diagnosis of LUTS

Your doctor will try to uncover any underlying cause of your lower urinary tract symptoms. Diagnostic methods may include examining the prostate, looking for any neurological condition, and running other tests to confirm a diagnosis of diabetes or other chronic health condition that could contribute to LUTS.

A blood test for glucose is used to determine a diabetes diagnosis. A urine dipstick uncovers any possible infection.

Other blood work can check kidney function and PSA.


You may also be asked to complete a urinary frequency chart, so your doctor can get an idea of the severity of your LUTS.

Treating Lower Urinary Tract Symptoms (LUTS)

Treatment for LUTS is generally targeting the cause. This could be treating a urinary tract infection, addressing the problem of an enlarged prostate, or fixing whatever else could be causing it. Combination therapies may be most successful in treating your LUTS. If medical treatment is unsuccessful, your doctor may advise surgery.

Speak to your doctor about appropriate treatment options for your lower urinary tract symptoms in order to get the most relief and improve your quality of life.



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