“All patients with bothersome LUTS especially if over activity such as urge, frequency, dysuria should be referred on.”

    Picture 25

    Causes:

     

    • Bladder outlet obstruction
    • Overactive bladder
    • Underactive bladder

     

    BOO

     

    Most commonly 2o benign prostate hyperplasia (BPH)

     

    DDXUrethral Structure

    • Prostate Cancer4
    • Detrusor Sphincter Dysenergia (spinal patients)
    • BN Hypertrophy/Contracture

    Tests

    • MSU – m/c/s
    • Renal U/S
    • UEC
    • PSA

     

    OAB

     

    Multiple causes

     

    • Primary – idiopathic
    • Secondary
          • BPH
          • UTI
          • Urothelial Cancer / Prostate Cancer
          • Bladder/VUJ stones
          • Neurogenic (spinal, parkinson’s, MS)

      Tests

       

          • MSU – m/c/s
          • Renal U/S (or CT IVP)
          • UEC
          • Urine Cytology x 3

       

      BLADDER HYPOCONTRACLILITY

       

      DDX

       

          • Chronic BOO (BPH, stricture etc)
          • Pelvic Surgery
          • CVA, DM

       

      Tests

       

          • MSU – m/c/s
          • Renal U/S
          • UEC