The evaluation and treatment of prostate-related LUTS in the primary care setting: the next STEP

The primary care provider is in an optimal position to identify and care for the patient affected by prostate-related lower urinary tract symptoms (BPH-LUTS). This assessment can be readily accomplished with a good history and only a few simple, in-office tests. In some instances, the primary care provider may believe that they do not have the experience, comfort level or time to perform an adequate evaluation of the problem. Therefore, in this article, we describe the function of the lower urinary tract, as well as the rationale behind the medical history, examination and tests needed in order to diagnose and treat, or refer, the patient presenting with BPH-LUTS. We will also update the literature-based STEP (simplified treatment of the enlarged prostate) approach, which was initially published in 2009, to include recently described therapeutic options.