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Lower Urinary Tract Symptoms (LUTS)
Overview
  • LUTS refer to a group of clinical symptoms involving the bladder, urinary sphincter, urethra and in men, the prostate as well.

  • LUTS may be divided into 2 categories:

    Storage symptoms

    • Increased urinary frequency during the daytime
    • Increased waking up at night to pass urine
    • Increased urinary urgency
    • Dysuria ('burning' sensation when passing urine)
    • Urinary leakage (incontinence)

    Voiding symptoms

    • Difficulty starting to pass urine (hesitancy)
    • Poor urine flow (slower speed)
    • Dribbling at the end of the urine stream
    • Feeling of incomplete voiding
  • Common causes of LUTS include:
    • Benign enlargement of the prostate (also known as BPH)
    • Prostate cancer
    • Urinary tract infections
    • Overactive bladder syndrome
    • Bladder cancer
  • Prostate cancer
    • Found mainly in older men aged >50 years old
    • Early prostate cancer is usually without any symptoms
    • As the prostate cancer progresses, the tumour may enlarge and narrow the urethra and one may experience lower urinary tract symptoms
    • If you are above 50 years old, or have a family history of prostate cancer, or are worried about prostate cancer, seek specialist evaluation at the Urology clinic
    • This will include a digital rectal examination and may include urine tests or blood tests such as prostate-specific antigen (PSA) test
  • Benign Prostate Hypertrophy (BPH)
    • Strictly speaking, it is only diagnosed histologically when a pathologist evaluates tissue samples of your prostate, which may be obtained during a prostate biopsy (usually performed via a transrectal approach), or from a transurethral resection of the prostate
    • This condition is suspected when one exhibits LUTS and prostate cancer is deemed unlikely after evaluation by a Urologist
    • It is usually managed conservatively with lifestyle changes and medication therapy
    • Some patients require surgery such as transurethral resection of prostate, which aims to clear a channel in the urine passage to allow better flow and emptying of urine (seen below)
  • Overactive Bladder Syndrome (OAB)
    • This is characterized by urinary urgency accompanied by frequency, occasionally with urinary leakage
    • It is a clinical diagnosis made after excluding other causes that cause similar symptoms e.g. urinary tract infection
    • After specialist evaluation, you may be referred to our Specialist Continence Nurse who will be able to educate you on:
      • Pelvic Floor Muscle Therapy (PFMT)
      • Lifestyle changes
      • Initiation of a 3-day bladder diary to help both you and our team understand your condition better
    • Some patients may require further evaluation with urodynamic studies
    • If PFMT and lifestyle changes are inadequate, medications can be started to alleviate the symptoms
This article was published by KTPH Urology and updated in 2026.