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Conservative Treatment of LUTS in Men in Primary Care

Over 12 months at 30 U.K. general practices, men who received a standardized and manualized intervention had a sustained reduction in lower urinary tract symptoms (LUTS), researchers report. The “practical resource” provided a method “to support symptom assessment and conservative treatment for LUTS in men in primary care,” the authors conclude. “Many of the symptoms managed in this way are also experienced by women, raising the possibility of developing an equivalent standardised and manualised approach to managing LUTS in female patients.”

A total of 1,077 adult men with bothersome LUTS were included in the cluster-randomized trial in 2018–19. Developed with patient and expert input, a standardized information booklet provided guidance on conservative and lifestyle interventions for LUTS in men. During the manualized element of the intervention, nurses and healthcare assistants familiarized patients with relevant sections of the manual. They contacted patients to support adherence over the following 12 weeks.

Based on a primary outcome of patient-reported International Prostate Symptom Score (IPSS) for 12 months after participants had provided consent, the study showed: “Participants in the intervention arm had a lower mean IPSS at 12 months (adjusted mean difference −1.81 points, 95% confidence interval −2.66 to −0.95) indicating less severe urinary symptoms than those in the usual care arm. LUTS specific quality of life, incontinence, and perception of LUTS also improved more in the intervention arm than usual care arm at 12 months. The proportion of urology referrals (intervention 7.3%, usual care 7.9%) and adverse events (intervention seven events, usual care eight events) were comparable between the arms.”

Source: BMJ