Aust Fam Physician
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Lower urinary tract symptoms are a common problem in men and the incidence of these symptoms increases with age. ⋯ Lower urinary tract symptoms may be divided into voiding and storage, and men may present with a combination of the two symptom groups. Voiding symptoms include weak stream, hesitancy, and incomplete emptying or straining and are usually due to enlargement of the prostate gland. Storage symptoms include frequency, urgency and nocturia and may be due to detrusor overactivity. In elderly men who present with lower urinary tract symptoms, indications for early referral to a urologist include haematuria, recurrent infections, bladder stones, urinary retention and renal impairment. In uncomplicated cases, medical therapy can be instituted in the primary care setting. Options for medical therapy include alpha blockers to relax the smooth muscle of the prostate, 5 alpha reductase inhibitors to shrink the prostate, and antimuscarinics to relax the bladder. The International Prostate Symptom Score is beneficial in assessing symptoms and response to treatment. If symptoms progress despite medical therapy or the patient is unable to tolerate medical therapy, urological referral is warranted.
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From April 2009 to March 2011 in BEACH, benign prostatic hyperplasia/hypertrophy (BPH) was managed at a rate of six per 1000 general practice encounters with male patients aged 18 years and over, suggesting it was managed by general practitioners about 228 000 times per year nationally.