Lower urinary tract symptoms in the older male.

Lower urinary tract symptoms (LUTS) are common in older men and include urinary frequency, urgency, nocturia and slow stream. Traditionally, this symptom complex has been called benign prostatic hypertrophy or prostatism, yet such symptoms may also result from detrusor over-activity and/or excessive urine output. Clinical assessment of older men with LUTS is based on a careful history, a clinical examination and a check of the postvoid residual, with urodynamic studies reserved for select individuals. Factors such as mobility, constipation and fluid balance must also be considered. These combined with a variety of pharmacologic agents (antispasmodics, alpha-antagonists, 5 alpha reductase inhibitors) offer great potential for improving the quality of life of individuals with LUTS.