Lower Urinary Tract Dysfunction
Male LUTS: keep on learning

James (55 years old)

James, a 55-year-old patent officer, experiences urgency (1-2 times/day), nocturia (1-2 times/night), intermittency and feeling of incomplete emptying.


Medical history: BMI: 33. Length: 175 cm. Weight: 100 kg. No other relevant comorbidities.
Physical examination: DRE: normal. Prostate volume: 30 ml.
Urinalysis: Normal.
IPSS: 12 (IPSS QoL: 4).
Flowmetry: Qmax: 10 ml/s. Voided volume: 170 ml. PVR: 160 ml.
Bladder diary: Frequency: day 6x, night 3x. Voided volumes: 130-230 ml. Urgency: 3x/day. Limited fluid intake.

Which treatment is the most appropriate to treat his LUTS?