Benign prostatic hyperplasia: symptoms, symptom scores, and outcome measures

The approach to a patient with benign prostatic hyperplasia and lower urinary tract symptoms (LUTS) begins with a detailed history. The goal is to clearly identify the patient's urinary complaints, including frequency of micturition, urgency, urge incontinence, weak stream, the need to push or strain, hesitancy, intermittency, dysuria, and hematuria. Bladder diaries and symptom questionnaires are useful as adjuncts to information that is acquired in the history. The voiding diary is an essential part of the workup. The voiding diary differs from a simple frequency-volume chart in that it incorporates not only the frequency, voided volume, urge episodes, pad usage, and fluid intake but also the data related to patient activities. It allows patients to have a more thorough self-evaluation of their LUTS.