Lower urinary tract symptoms (LUTS) 

What is LUTS?

Lower Urinary Tract Symptoms (LUTS) — also known as urinary problems — covers a broad range of symptoms. These symptoms can be group into issues with storing urine or issues passing (voiding) urine.

Voiding symptoms include a weak stream, trouble starting or maintain urine flow (hesitancy), and incomplete emptying or straining. Storage symptoms include the need to urinate frequently or urgently, and nocturia (frequent night-time urination).Men may present with a combination of the two symptom groups and the type and severity of symptoms can have differing impacts on day-to-day life.

LUTS will be experienced by most people. Around one in 14 men in their 40s and nearly one in three men over the age of 70, report moderate to severe LUTS. Although urinary problems are common in men, particularly as they get older, it can be a tough topic to discuss. Your loved one might be going to great lengths to hide or deny the issue, but those closest to them are important allies in managing the obstacles these symptoms present.

Learn more about urinary problems on our health topic page.

What are LUTS?

If you have a loved one with LUTS, you might notice them:

• Wake from sleep to pass urine a night more than normal

• Need to visit the toilet urgently or frequently

• Experience dribbling after urination has finished (so there might be more laundry or they might frequently change their clothes)

• Have ‘accidents’

• Be reluctant to leave the house or go to places where they can’t be sure they can get to a toilet quickly

Symptoms your loved one might notice and discuss with you:

• Longer than usual wait for the stream of urine to begin

• Weak stream

• Straining to urinate

• A stream that stops and starts

• Feeling like their bladder isn’t empty when they finish urinating

What causes LUTS?

LUTS aren’t a normal part of ageing. Your loved one needs to see a doctor if they’re experiencing changes to urination, particularly if the symptoms are affecting their quality of life or interfering with normal daily activities.

LUTS are always a sign of an underlying condition, which could threaten your partner’s health but can often be resolved. Causes of LUTS include urinary tract infections, inflammation of the prostate gland (prostatitis), benign prostatic hyperplasia (BPH), underlying medical conditions, or as a result of prostate surgery. Treatment depends on the symptoms, but there are options available to cure or manage LUTS.

Reducing caffeine and alcohol intake (these substances can irritate the bladder), avoiding large amounts of fluid before bed, preventing constipation (straining to pass stools can affect pelvic floor muscles, which are important for both bowel and bladder control), and losing weight might help to improve symptoms.

What someone with LUTS could be feeling

The type and severity of lower urinary tract symptoms can have differing impacts on day-to-day life.

Overall LUTS is linked to increased anxiety and depression, and people with LUTS report a significant impact on quality of life, affecting physical, social and sexual function. Symptoms associated with storage of urine, such as urinary incontinence, have an even greater impact on quality of life and affect one’s sense of privacy, self-esteem and dignity.

Your loved one might be feeling isolated, hopeless, embarrassed and a loss of control and confidence. They might be anxious to leave the house not knowing where the nearest bathroom is, concerned about possible underlying conditions like cancer, worried about increasing health costs or reluctant to be a burden on others. These feelings might cause them to withdraw from social and romantic relationships, and you might notice these mood changes before they’ve discussed any physical symptoms with you. You may find these behaviours difficult to understand and accept, making it harder for you to help the person achieve the best outcomes for you both.

What you might be feeling

If your partner has LUTS, it can also affect your quality of life too. You might feel increased fatigue due to sleep disturbances, additional stress over the management of their condition, and limitations on their activities can see your social life change or influence how you share household duties. You might also feel the effect of LUTS on your relationship, reducing physical intimacy and communication, increasing conflict and feelings of distance and withdrawal, and impacting your sex life. It’s important to acknowledge the feelings you have about your partner’s symptoms and take care of your wellbeing too. Chat to your GP or a counsellor who will offer support and strategies for navigating the situation.

Concerns about LUTS can also affect other family members such as children, grandchildren and siblings, for example. Supporting a family member with LUTS can feel embarrassing or invasive. Depending on the type and severity of the symptoms and the extent of your involvement as a caregiver, it can impact your quality of life to varying degrees.

What you can do about LUTS

Start a conversation. One in three men bothered by LUTS do not see a GP and younger men are less likely to seek professional help. Men are also more likely to discuss the problem with a personal contact like a spouse or partner than a health professional. As they get older, they’re more likely to seek support from their children².

There are some ways to broach the subject effectively.

1. Choose the right time and place

Find an environment without interruption and pick a time that your loved one won’t feel particularly vulnerable or uncomfortable. Don’t try to broach the subject after an accident, during an intimate moment or before bed. A more comfortable time could be during a walk or a drive, where you’re shoulder-to-shoulder rather than face-to-face.

2. Show you’re understanding

Learning more about the condition, and how they might feel about it, can help you offer effective support. Being met with impatience or indifference can make a person with LUTS feel more isolated. Try to be empathetic, positive, and honest about how you’re feeling as well.

3. Encourage them to seek help

LUTS isn’t always something you have to live with and determining the underlying cause will help with treatment. Encourage your loved one to book an appointment with a GP to discuss their symptoms and the impact they’re having.

Learn more about urinary problems on our health topic page.