• approach similar

• incontinence subset of LUTS

  • Lower urinary tract symptoms

    • post-void dribbling

    • obstruction and overflow

    • nocturia

    • urgency

• liklihood of signifiant underlying cause higher in men

• investigation a lways necessary

• usually prostate abnormalities or neurological

• DRE:

  • size and consitency of prostate and examine for nodule,s, tendnerss and masses

  • pelvic floor musculature

Investigations

• perform dipstick

• serum creatinine

  • if any:

    • chronic urinary retuention

    • recurrent UTI

    • history of stones

• bladder diary

Management

Stress - caused by prostatectomy

• referred to continence nurse

• supervised pelvic floor muslce

Stress - not caused by prostatectomy

• referred to urologist

Urgency and overactivity

• exclude/manage all treatable cause

• BPH - alpha blockers

• bladder retraining

• oxybutynin

• referral