Fortnightly Review: Managing lower urinary tract symptoms in older men

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Abstract
The presence of lower urinary tract symptoms does not indicate bladder outlet obstruction Size of the prostate does not correlate with bladder outlet obstruction: small prostates may cause severe obstruction Bothersomeness and effect on quality of life are the preferred indicators for treatment Conservative treatment is justified by the long clinical course of the conditions Drugs are of some help and are becoming safer Transurethral resection of the prostate is the only procedure known to give good long term results New alternatives to transurethral resection of the prostate should only be used within the context of randomised controlled trials at present