Editing CUA: Male LUTS & BPH (2018) (section)

== Diagnostic and Evaluation ==

* '''Mandatory (2):'''
*# '''History''' (symptom severity and bother, medical history) + '''physical exam (including DRE)'''
*# '''Urinalysis (routine and microscopic, culture and sensitivity)'''
* '''Recommended (2):'''
*# '''Symptom inventory''' (should include bother assessment), '''for example International Prostate Symptom Score (IPSS) or AUA Symptom Score''', is recommended for an objective assessment of symptoms at initial contact, for follow-up of symptom evolution for those on watchful waiting, and for evaluation of response to treatment.
*#* '''IPSS domains FUNWISE + QOL'''
*#** '''Frequency'''
*#** '''Urgency'''
*#** '''Nocturia'''
*#** '''Weak stream'''
*#** '''Intermittency'''
*#** '''Straining'''
*#** '''Emptying, incomplete'''
*#** '''+Quality of life'''
*#* '''IPSS score:'''
*#** '''Mild: 1-7'''
*#** '''Moderate: 8-18'''
*#** '''Severe: 19-35'''
*# '''PSA (selected patients):''' should be offered to patients who have ≥ 10-year life expectancy and for whom knowledge of the presence of prostate cancer would change management, as well as those for whom PSA measurement may change the management of their voiding symptoms (estimate for prostate volume). Among patients without prostate cancer, serum PSA may also be a useful surrogate marker of prostate size and may also predict risk of BPH progression.
* '''Optional (6):'''
** '''In cases where the physician feels it is indicated, it is reasonable to proceed with one or more of the following:'''
**# '''Uroflowmetry'''
**# '''Post-void residual (recommend frequency volume chart for men with suspected nocturnal polyuria)'''
**# '''Serum creatinine'''
**# '''Urine cytology (if irritative symptoms are significant component of LUTS)'''
**# '''Voiding diary'''
**# '''Sexual function questionnaire'''
* '''Not Recommended,''' but may be required in patients with a definite indication, such as hematuria, uncertain diagnosis, DRE abnormalities, poor response to medical therapy, or for surgical planning.
** '''Cystoscopy'''
** '''Prostate ultrasound'''
** '''Urine cytology'''
** '''Urodynamics'''
** '''Upper urinary tract imaging'''
** '''Prostate biopsy'''
* '''Preoperative testing'''
** '''Determination of prostate size and extent of median lobe are related to procedure-specific indications.'''
** '''Cystoscopy should be performed to evaluate prostate size, as well as presence or absence of significant middle/median lobe.'''
** '''Ultrasound is recommended if further information in regard to size of prostate and extent of median lobe presence is required when choosing modality of surgical therapy.'''