Investigations

Initial assessment refers to assessment carried out in any setting by a healthcare professional without specific training in managing LUTS in men (1)

• at initial assessment, ask men with bothersome LUTS to complete a urinary frequency volume chart
  
  
• offer men with LUTS a urine dipstick test to detect blood, glucose, protein, leucocytes and nitrites
  
  
• NICE suggest that men with LUTS a serum creatinine test at initial assessment (plus estimated glomerular filtration rate [eGFR] calculation) only if suspect renal impairment (for example, the man has a palpable bladder, nocturnal enuresis, recurrent urinary tract infections or a history of renal stones)
  • - 80% of renal function must be lost before creatinine rises
• cystoscopy should not be routinely offered to men with uncomplicated LUTS (that is, without evidence of bladder abnormality) at initial assessment

Notes:

• other investigations often undertaken in primary care include:
  • FBC - especially if contemplating surgery
  • MSU - microscopy and culture to exclude UTI
  • prostate specific antigen (PSA)

Reference:

• 1) NICE (June 2015). Lower urinary tract symptoms The management of lower urinary tract symptoms in men