Lower Urinary Tract Symptoms are common urologic complaints among men over the age of 50. Causes may include benign enlargement of the prostate or changes in the urinary tract. Treatment depends on the primary cause.
What are lower urinary tract symptoms?
The lower urinary tract includes several structures. In addition to the urinary bladder, the urethra is the main part of the lower urinary tract. In English, the term “lower urinary tract” encompasses the two urinary tract structures. Complaints of the lower urinary tract mainly affect older men. The symptomatology consisting of urethral and urinary bladder symptoms is summarized by the term Lower Urinary Tract Symptoms. These lower urinary tract symptoms or lower urinary tract symptomatology can occur during urine collection as well as urinary bladder emptying. Lower urinary tract symptoms are a common disease. In the group of men over 50 years of age, up to 30 percent suffer from lower urinary tract symptoms that require therapy. Bladder voiding dysfunction is the most common of these. Lower Urinary Tract Symptoms are not limited to the human race, but are also common in the animal kingdom. In cats, for example, these same symptoms are referred to as Feline Lower Urinary Tract Disease.
Causes
Lower urinary tract symptoms can result from a wide variety of causes. Age-physiologically, men begin to experience changes in the urinary tract after the age of 50. One common change is prostatic hyperplasia, which manifests as an increase in the size of the organ and presses on organs and anatomic structures in the immediate vicinity. Prostatic hyperplasia is considered the most common cause of Lower Urinary Tract Symptoms. However, theoretically, inflammation can also lead to the symptoms. In extreme cases, the trigger of the symptoms is a tumor in the area of the urinary bladder or on the prostate. Anatomical deformations of the urinary tract are also conceivable causes, such as a narrowing in the area of the bladder neck. This narrowing can be present in normal-sized or hyperplastic prostates. The investigation of the cause of Lower Urinary Tract Symptoms is correspondingly complex and requires extensive examinations by a urologist.
Symptoms, complaints, and signs
Lower Urinary Tract Symptoms specifically include sudden urge to urinate with urge incontinence. Many patients experience delayed onset of bladder emptying even though they are afflicted with a strong urge to urinate. Their urge to urinate is often so unexpected and sudden that they can hardly reach the toilet in time. To actually urinate, many of those affected have to push extraordinarily hard. Despite all efforts, their urine stream remains unusually weak in many cases. As a result, patients often take longer than usual to empty their bladders. In addition, most of those affected do not have the feeling that the bladder has been emptied sufficiently. A permanent residual urine sensation remains after each micturition. In most cases, there is a renewed urge to urinate shortly after a micturition. These symptoms may be associated with micturition disorders such as dribbling urine. Which of the above symptoms are actually present in individual cases varies from case to case. Lower Urinary Tract Symptoms can include many other symptoms depending on the primary cause. Thus, it is not a uniform clinical picture.
Diagnosis and disease course
The urologist makes the diagnosis of lower urinary tract symptoms after taking a detailed history. In the diagnostic process, causation is sometimes the most decisive factor. The standard urological examination can provide information about possible prostatic hyperplasia. Clarification of the cause is all-important for effective therapy.
Complications
Lower Urinary Tract Symptoms usually summarize various complaints and symptoms that generally lead to a significant reduction in quality of life. Most of those affected suffer primarily from a so-called residual urinary sensation, which can not infrequently lead to psychological discomfort or even depression. Furthermore, lower urinary tract symptoms lead to urge incontinence, so that those affected can no longer reach the toilet in time.Especially in stressful situations, these symptoms can become very unpleasant and lead to sweating or panic attacks. It is not uncommon for patients to feel ashamed of Lower Urinary Tract Symptoms and to delay a visit to the doctor, which is why treatment is usually initiated late. However, life expectancy itself is not affected or reduced by Lower Urinary Tract Symptoms. Treatment of these symptoms is always causal and depends on the underlying disease. In most cases, the symptoms can be relatively well limited by various trainings and therapies. If a tumor triggers the Lower Urinary Tract Symptoms, it must be removed. This may also reduce the patient’s life expectancy in some circumstances.
When should you see a doctor?
If irregularities in urination occur, observations should be discussed with a physician. Permanent urination is unusual. A visit to the doctor should be made if the symptoms persist for several days or increase in intensity. Incontinence is also one of the health signs that should be examined and treated by a physician. If the affected person has to push unusually hard when emptying the bladder, this should be discussed with a doctor and should be checked by various examinations. If the urine stream remains weak even when the bladder is full, a physician should be consulted. A feeling of residual urine in the bladder is another indication of an existing inconsistency that should be clarified by a doctor. If there is a renewed urge to urinate immediately after successfully going to the toilet, a health disorder is present. A doctor should be consulted so that the cause of the irregularity can be diagnosed and treated as quickly as possible. Since residual urine in the bladder contributes to the development of undesirable bacteria, the patient needs early medical attention for existing symptoms. A visit to the doctor should therefore be sought only a few days after the development of problems, even if there is no evidence of pain or further impairment in the performance of everyday duties.
Treatment and therapy
Patients with lower urinary tract symptoms are usually treated causally. Any causative treatment aims to eliminate the trigger. Once the cause is resolved, the symptoms also resolve. Depending on the primary cause of the symptoms, different treatment options are available. As a rule, the therapy embraces conservative medicinal procedures. Since the most common cause of lower urinary tract symptoms is benign prostatic hyperplasia, the causative treatment usually involves the use of 5-alpha-reductase inhibitors, drugs such as alpha blockers or the active ingredients of PDE-5 inhibitors. If no improvement of the symptoms can be achieved with medication, invasive treatment procedures can be considered. Such invasive procedures usually involve surgery to remove the excess prostate tissue. If there is a malignant change in the prostate, ideally complete removal of the tumor is required. Combined measures such as chemotherapy and radiation therapy are decided primarily by the malignancy of the tissue. A similar procedure applies to bladder tumors. Inflammatory changes of the lower urinary tract are usually treated with antibiotics. Most often, inflammations are reactions caused by carried bacteria from the patient’s own body. If there are narrowings of the urinary tract, these narrowings are widened by surgical incisions.
Outlook and prognosis
The prognosis of urinary tract changes depend on the causative triggers of the disease. Under optimal conditions and early diagnosis as well as therapy, relief of symptoms and ultimately freedom from symptoms can be achieved in a large number of affected individuals. Nevertheless, a chronic course of the disease is also possible. This often leads to complications or secondary diseases. The health impairments lead to psychological complaints and irregularities in many patients. Therefore, those affected are at increased risk of suffering from mental disorders. This has a negative effect on the overall prognosis, since the quality of life is permanently impaired as a result. Normally, a drug therapy takes place.This should trigger an improvement in the symptoms. Nevertheless, the administration of drugs is associated with the possibility of side effects. Alternatively, surgical procedures are used to remove a narrowing of the urinary tract. Surgery is also associated with risks and can lead to lifelong impairments if the process is disrupted. Tumors develop in severe cases of disease progression. Since these represent a fundamentally life-threatening situation for the patient, the prognosis worsens considerably when cancer develops. Surgical intervention as well as cancer therapy are necessary, as otherwise the affected person may die prematurely.
Prevention
Lower Urinary Tract Symptoms are a common disease. Nearly one in three men will develop them in his lifetime. This relationship is due to the age physiological changes in the urinary tract. The individual symptoms can therefore only be prevented to a certain extent. The focus of possible preventive measures in connection with prostatic hyperplasia is, for example, diet. The consumption of vegetables, for example, should be able to prevent the phenomenon to a certain extent. In addition, physical activity lowers the risk of developing prostate symptoms. Excess weight increases the risk of the disease and should therefore be reduced as much as possible.
Follow-up care
Because treatment of lower urinary tract symptom is relatively complex and lengthy, follow-up care focuses on safe management of the condition. Affected individuals should try to focus on positive coping despite the adversity. To build the appropriate mindset, relaxation exercises and meditation can help calm the mind. This is a fundamental requirement for partial recovery. Relaxation exercises can ensure to take away some of the mental tension, which can alleviate the constant fear of unpredictability. Lower Urinary Tract Symptom leads to a significantly reduced quality of life in the sufferer. Most patients suffer from depressive moods. Sometimes it can help to have this treated by a psychologist. Whether this can lead to a complete cure cannot be universally predicted. As a rule, this disease does not reduce the life expectancy of the affected person.
What you can do yourself
The mostly older, male patients of Lower Urinary Tract Symptom usually suffer causally from an enlarged prostate. However, it does not have to be cancer. A benign enlargement, called benign prostatic hyperplasia, also causes symptoms such as excessive urination or urge incontinence, but also the opposite symptoms such as delayed bladder emptying, a weak urge to urinate or dribbling urine. Even an inflammation could cause these symptoms, so patients should definitely have a urologist clarify what is behind their symptoms as early as possible. This is the only way to initiate appropriate therapies in good time, which in the best case will lead to a complete cure of the underlying disease. If all therapeutic measures (medicinal or invasive) have been exhausted, patients can be helped by bladder or pelvic floor training. The aim is to extend the time between two visits to the toilet as long as possible. The urologist treating the patient can help with addresses and contacts. Problems with urination cause stress. Relaxation exercises are therefore also recommended. Progressive muscle relaxation according to Jacobson is very effective and easy to learn. But meditation and breathing exercises, as taught in yoga, also bring relaxation. It is important to perform the exercises consistently and regularly if they are to be successful.