Initial management of lower urinary tract symptoms

BPH: benign prostatic hyperplasia; DRE: digital rectal examination; LUTS: lower urinary tract symptoms; OAB: overactive bladder; PSA: prostate-specific antigen.

* When life expectancy is >10 years and if the diagnosis of prostate cancer can modify the management.

¶ When significant nocturia is a predominant symptom.

Δ Assess and start treatment before referral.

◊ In practice, advise patients with symptoms to aim for a urine output of approximately 1 liter/24 hours.

§ Desmopressin carries a risk of adverse effects, including severe hyponatremia. Given the potential for significant harm and the need for frequent laboratory monitoring, we use a shared decision-making process when offering this therapy. Please refer to related UpToDate content for further detail.