Lower Urinary Tract Dysfunction

Retention

Acute causes - BPH, Urethral stricture (recent trauma/catheterisation), or UTI

• Managed with Catheterisation and a-blocker (e.g. tamsulosin)

Chronic causes - BPH, Prostatitis, Tumour

• Managed with U&Es and Urology referral

Incontinence

Urge - Due to detrusor overactivity causing symptoms of urgency. Social history is very important here as the urgency can be very embarrassing for patients, having a significant impact on their quality of life.

Stress - Due to weakness of pelvic floor and sphincter muscles, allowing urine to leak when there’s increased intra-abdominal pressure e.g. laughing, coughing, sneezing, exercise.

Overflow - Small leaks of urine w/o warning – This occurs when pressure in the bladder overcomes the pressures of the outlet. It's due to:

• Detrusor underactivity e.g. Anticholinergics, MS, DM, Tumours

• High urinary outlet pressures e.g. BPH, prostatism, constipation