Lower Urinary Tract Symptoms (LUTS)

What are lower urinary tract symptoms?

Lower urinary tract symptoms (LUTS) are experiences you might have if you have issues with parts of your urinary tract, like your bladder or urethra.

Lower urinary tract symptoms include:

• Feeling like you can’t empty your bladder or that it fills up too quickly
• Having more pee than usual when you go, or needing to pee frequently
• Waking up to pee often
• Having sudden urges to pee that are difficult to control
• Weak urine stream or one that starts and stops
• Dripping or dribbling pee
• Leaking pee when you sneeze, cough, laugh or have sex, or while you’re on your way to the bathroom
• Straining to pee
• Pain when you pee

See a healthcare provider right away if you have blood in your pee or feel pain when you pee.

What are the most common causes of lower urinary tract symptoms?

Irritation, infection or a blockage in parts of your urinary tract are the most common causes of lower urinary tract symptoms. Specific causes include:

• Bladder outlet obstruction
• Constipation
• Enlarged prostate (benign prostatic hyperplasia/BPH)
• Kidney stones or cysts
• Neurological conditions (neurogenic bladder)
• Obstruction or narrowing of your urethra
• Overactive bladder
• Pelvic floor dysfunction
• Tumors, like prostate cancer
• Urinary tract infections (UTIs)

You might also experience LUTS if you have:

• Diabetes
• Erectile dysfunction
• High blood pressure (hypertension)
• Nicotine, caffeine and alcohol use
• Obesity
• Sleep apnea
• Thyroid disease

How do doctors diagnose the cause of lower urinary tract symptoms?

To diagnose possible causes of lower urinary tract symptoms, a healthcare provider will perform a physical exam. They’ll ask you questions about your symptoms, like how long you’ve had them and if they’re better or worse at certain times of the day. They might also ask you about medications and supplements you’re taking and whether you drink caffeine or alcohol.

Your provider also might recommend testing, including:

• Blood tests
• Urinalysis (urine test)
• Prostate exam
• Ultrasound or other imaging
• Post-void residual urine test
• Urodynamic testing
• Cystoscopy

How are LUTS treated?

Treatment options for lower urinary tract symptoms depend on the cause and how the symptoms affect your life. Your provider might recommend:

• 5-alpha reductase inhibitors to treat an enlarged prostate
• Antibiotics to treat infections
• Alpha-blockers to relax your bladder
• Blood pressure medications to relax blood vessels and lower blood pressure
• Muscle relaxants for your urinary or digestive tract
• Pelvic floor physical therapy
• Surgery to remove blockages or reduce the size of your prostate

They might also suggest things you can do at home to help your symptoms. These could include:

• Adjusting the amount of fluids you drink or the times of day you drink them
• Changing certain medications you take
• Going to the bathroom at scheduled intervals throughout the day
• Limiting or eliminating nicotine, caffeine and alcohol
• Maintaining a weight that’s healthy for you
• Strengthening your pelvic floor muscles with Kegel exercises

When should I seek medical treatment for LUTS?

Talk to a healthcare provider if you have any lower urinary tract symptoms. Even mild symptoms are worth mentioning, as treatment can be more effective if started early.

Seek medical attention right away if you have blood in your pee or you’re in pain. It’s also especially important to talk to your provider if your symptoms are:

• Keeping you from getting a good night’s sleep
• Preventing you from doing the things you enjoy or leaving your house
• Causing anxiety or depression
• Affecting your relationships, like making you avoid social situations, intimacy or sex