What initial assessments should I perform for a male patient presenting with lower urinary tract symptoms (LUTS)?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

At initial assessment, offer men with LUTS an assessment of their general medical history to identify possible causes of LUTS and associated comorbidities. Review current medication, including herbal and over-the-counter medicines, to identify drugs that may be contributing to the problem.

At initial assessment, offer men with LUTS a physical examination guided by urological symptoms and other medical conditions, an examination of the abdomen and external genitalia, and a digital rectal examination.

Ask men with bothersome LUTS to complete a urinary frequency volume chart.

Offer men with LUTS a urine dipstick test to detect blood, glucose, protein, leucocytes, and nitrites.

Offer advice and information on their condition, including lifestyle interventions, and discuss whether they wish to have prostate-specific antigen (PSA) testing if indicated (e.g., abnormal DRE, LUTS suggestive of bladder outlet obstruction).

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