This guideline covers managing lower urinary tract symptoms (LUTS) in men over 18. It aims to improve the quality of life for men with LUTS by recommending which assessments they should receive, and when conservative management, drug treatment and surgery can help.

In June 2015, we reviewed the evidence for phosophodiesterase-5 inhibitors, and added recommendation 1.4.10 on when to use them. We also added a recommendation for research on the clinical and cost effectiveness of phosophodiesterase-5 inhibitors in men who do not have erectile dysfunction.


This guideline includes recommendations on:

Who is it for?

  • Healthcare professionals
  • Commissioners and providers
  • Men with lower urinary tract symptoms and their families or carers

Is this guideline up to date?

May 2023: We have reviewed our guidelines portfolio to identify topics that we think will add the most value to the health and care system and have agreed the update recommended in this surveillance report will not proceed as planned.

Guideline development process

How we develop NICE guidelines

This guideline updates and replaces NICE interventional procedures guidance IPG15 (February 2003), IPG120 (February 2003), IPG224 (July 2007) and IPG256 (March 2008), and evidence summary ESNM18.

This guideline was previously called lower urinary tract symptoms: the management of lower urinary tract symptoms in men.

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.