ABSTRACT
Men rarely complain of a big prostate, but usually present with lower urinary tract symptoms (LUTS) or a complication from unrelieved bladder outflow obstruction (BOO) ( Table 26.1 ). The cause of their symptoms is not always the prostate! Females develop similar symptoms as they age. Bladder neuromuscular changes associated with aging lead to over-activity of the bladder, and endocrine, cardiac, renal, dietary (especially fluid), and pharmacological effects can all lead to LUTS, especially passing urine frequently, urgently, and at night (frequency, urgency, and nocturia), which are the most bothersome symptoms and most likely to bring a patient to see a doctor. A range of conditions may therefore precipitate a consultation for advice and treatment, and the advisor will need to work through them to determine the primary causes.
