Diagnosis should include a careful history and directed physical examination.

Men with the following features should be referred urgently to a urologist:[15][16]

  • Microscopic or macroscopic haematuria: increases the possibility of prostate or bladder cancer

  • Neurological disease (such as long-standing diabetes): may suggest neurogenic bladder

  • History of prior urological surgeries and urethral stricture

  • History of recurrent infection

  • Palpable bladder

  • Renal impairment that is attributed to lower urinary tract dysfunction

  • Abnormal digital rectal exam suggesting prostate cancer

  • Abnormal prostate-specific antigen (PSA) levels.

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