Symptoms

Patients may complain of obstructive voiding symptoms (e.g., urinary hesitancy, decreased force of urinary stream, straining to void, incomplete bladder emptying, dribbling, and intermittency) and/or irritative voiding symptoms (e.g., urinary frequency, nocturia, dysuria, urgency, and urinary incontinence). Severity of symptoms should be assessed by the patient using a standardized instrument (e.g., the American Urological Association [AUA] Symptom Scoring Index; Table 52-1). However, it is important to recognize that a patient's perception of the bothersomeness of his voiding symptoms may not match with the AUA Symptom Score. In this case, after thorough evaluation of the signs and complications of BPH disease, if present, the physician and patient should discuss the bothersomeness of the patient's symptoms and decide together on the most appropriate course of treatment for the patient. ,10 Lower urinary tract symptoms (LUTS) is a term that refers to the collection of obstructive and irritative voiding symptoms characteristic of, but not specific for, BPH. That is, other urologic diseases (e.g., urinary tract infection, prostate cancer, prostatitis, or neurogenic bladder) can also cause LUTS.

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