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IntroductionLower urinary tract symptoms (LUTS) is a bothersome condition affecting older men which can lead to poor quality of life. General practitioners (GPs) currently have no easily available assessment tools to help effectively diagnose causes of LUTS and aid discussion of treatment with patients. Men are frequently referred to urology specialists who often recommend treatments that could have been initiated in primary care. GP access to simple, accurate tests and clinician decision tools are needed to facilitate accurate and effective patient management of LUTS in primary care.Methods and analysisPRImary care Management of lower Urinary tract Symptoms (PriMUS) is a prospective diagnostic accuracy study based in primary care. The study will determine which of a number of index tests used in combination best predict three urodynamic observations in men who present to their GP with LUTS. These are detrusor overactivity, bladder outlet obstruction and/or detrusor underactivity. Two cohorts of participants, one for development of the prototype diagnostic tool and other for validation, will undergo a series of simple index tests and the invasive reference standard (invasive urodynamics). We will develop and validate three diagnostic prediction models based on each condition and then combine them with management recommendations to form a clinical decision support tool.Ethics and disseminationEthics approval is from the Wales Research Ethics Committee 6. Findings will be disseminated through peer-reviewed journals and conferences, and results will be of interest to professional and patient stakeholders.Trial registration numberISRCTN10327305.

Portrait: Angela Rosenfeld Paul Schatzberger couldn’t decide between medicine and music. But ultimately creativity ran through everything he did in life. He grew up in Manchester, the son of Jewish Viennese child refugees Rosl and Wolfgang. Paul’s love of music grew with violin lessons from the age of 6 and was further encouraged by his father, who taught him to play Viennese music on a piano accordion. Paul’s grandmother had been a concert pianist in Vienna before her life ended in Auschwitz. In 1967, as he finished school, Paul was chosen by the Bridge of Britain Programme—a non-denominational, educational charity aimed at fostering “understanding between Britain and Israel, Jew and non-Jew, through practical educational and mainly social service exchange schemes.” He was selected because he was considered to be a significant young person who would be likely to make a difference in the world. He took his accordion and lived in a Kibbutz for six months. At medical school his violin playing led him to become the leader of the …