What are LUTS treatments & investigations?
LUTS treatments & investigations refer to the diagnosis and treatment of lower urinary tract symptoms (LUTS), which are related to problems concerning the lower urinary tract. The lower urinary tract consists of the bladder, the prostate and the urethra.
We can class LUTS as a broad group of symptoms which are related to the storing or passing of urine. Symptoms can be linked to one or both issues. Common causes of LUTS include a urinary tract infection, a benign prostate gland enlargement, an inflammation of the prostate, or an overactive bladder.
The prostate is a small gland in the pelvis only found in men. It's located between the penis and bladder and surrounds the urethra (the tube that carries urine from the bladder to the penis).
If the prostate becomes enlarged, it can place pressure on the bladder and urethra. This can cause symptoms that affect urination.
There are several treatments for LUTS - from lifestyle changes to addressing related health conditions and medications. Finally, there are several surgical procedures - which we will detail on this page.
It is understood that men with LUTS have significantly more chance of having erectile dysfunction than those without urinary symptoms. For this reason, LUTS treatments could also be effective in treating erectile dysfunction.
Am I a good candidate for LUTS treatments & investigations?
You might require LUTS treatments and investigations if you experience typical LUTS symptoms such as; a weak stream when urinating; an abnormally long wait (hesitancy) when urinating; dribbling after urination; straining while urinating; an intermittent stream; feeling a sudden and urgent need to urinate; waking up to urinate twice or more each night; urinating without control; or an abnormally short time between feeling the urge to urinate.
How do LUTS treatments & investigations work?
If you notice changes to your urination, such as the symptoms outlined above, you should see your doctor. Investigations to establish whether you have LUTS can include; questions from your doctor, a review of your medical history, and examinations such as post-void bladder scanning, flow rate, urinalysis and routine blood tests.
The first treatments suggested for LUTS can be lifestyle changes such as reducing alcohol or caffeine intake, as these substances may both irritate the bladder. These lifestyle changes may require you to exercise more or alter your diet, in order to address conditions such as obesity, hypertension or diabetes.
Medicines to treat LUTS include anticholinergic, combination treatments, alpha-blockers (tamsulosin), phosphodiesterase-5 inhibitors, and 5 alpha reductase inhibitors (finasteride)
For severe LUTS and very bothersome symptoms surgery may be recommended.
Once all of your investigations have been performed and the results are through then Mr Kaba will explain everything to you. He will discuss all the options with you and put forward an appropriate tailored management plan.
Surgery for prostate enlargement:
TURP is an operation to remove some of the enlarged prostate gland to relieve pressure on the urethra and allow the urine to drain more easily.
For some patients a TURP might be a better way of removing a larger amount of tissue and give a better resolution of symptoms in men with bigger prostates and those with significant urinary retention. The operation is performed under a spinal or a general anaesthetic and a telescope is passed into the bladder via the urethra. The obstructing part of the prostate is then removed by cutting away pieces of the prostate using a heated wire loop.
Patients have a catheter in place for 1-2 days and are usually discharged on the day of removal. It may take up to 3 months before all the irritation associated with the operation settles although the majority of patients will feel the benefit as soon as the catheter is removed.
There is a chance of erectile problems in the order of 5-10% following the TURP.
The UroLift® system received Interventional Procedures Guidance from NICE in January 2014.
The UroLift® is a minimally invasive treatment option for patients with urinary symptoms secondary to BPH. This treatment directly opens a channel in the anterior of the prostatic urethra by retracting the obstructing prostatic lobes without cutting, heating or removing prostate tissue. The prostatic lobes are retracted by using small permanent implants. Clinical data has shown the following:
- Rapid symptom relief as early as 2 weeks post-procedure with only mild urinary discomfort post-procedure during the recovery period
- Successful prostatic urethral opening is endoscopically confirmed immediately post-procedure
- Majority of patients do not require post treatment catheterization
- There have been no reports of new onset of sexual dysfunction, retrograde ejaculation or permanent erectile dysfunction following treatment with the UroLift® System.
Patients most suitable for this new treatment:
- Patients with prostates 80cc and smaller, not in retention, with little to no median lobe and no prostate cancer
- Patients that have tried drug therapies but can’t tolerate the side effects or are no longer obtaining any benefit from drug therapy
- Patients with significant urinary symptoms that possibly need surgical intervention but don’t want to lose sexual function
- Patients that want a minimally invasive procedure with a faster recovery time than conventional procedures
State-of-the-art treatments and investigations
Mr Kaba performs a wide range of cutting-edge, advanced urology treatments. He is skilled in minimally invasive procedures, offering more options to patients in their treatment of urologic disease.