The assessment of continence problems in adults.

Symptoms examined in a level 1 assessment In the report The Standardisation of Terminology of Lower Urinary Tract Function, Abrams at al (2002) divide lower urinary tract symptoms (LUTs) into three groups: ■ Storage symptoms – experienced when urine is stored in the bladder. These include increased daytime frequency and nocturia (Box 1); ■ Voiding symptoms – these include a slow urinary stream, spraying, straining and an intermittent stream; ■ Post-micturition symptoms – these include feelings of incomplete emptying, and post-micturition dribble. Level 1 assessment is suitable for patients with urine storage symptoms (Box 1). It could be suggested that those with voiding and post-micturition symptoms should be referred for level 2 or 3 assessment. Urinary symptoms are sometimes linked to storage and voiding problems, so referral for higher-level assessment must be made if there is doubt about the diagnosis.