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Lifestyle and behavioural interventions for men on watchful waiting with uncomplicated lower urinary tract symptoms: a national multidisciplinary survey
Author(s) -
Brown C.T.,
Van Der Meulen J.,
Mundy A.R.,
Emberton M.
Publication year - 2003
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1046/j.1464-410x.2003.04268.x
Subject(s) - psychological intervention , medicine , lower urinary tract symptoms , family medicine , nocturia , physical therapy , urinary system , nursing , prostate , cancer
Authors from London sent a survey to British urologists, nurse practitioners and continence advisors to determine the use of lifestyle and behavioural interventions in the UK for symptom control in men with uncomplicated urinary tract symptoms in the event of a watchful waiting policy being adopted. There was an 83% response rate, and the results showed that these interventions are indeed advised by many in such circumstances; however, the wide variation in their use has lead to the suggestion by the authors that it is necessary to test their effectiveness.A further article from the same institution attempts to highlight the importance of methodological standards in diagnostic testing by reviewing the extent of compliance with these standards in report of evaluations of, in this case, uroflowmetry, in the medical literature. They found that the evaluations assessed showed poor compliance, and felt that this had a negative effect on cost‐effectiveness and health‐case resourcesOBJECTIVE To determine the use of lifestyle and behavioural interventions in the UK for symptom control in men with uncomplicated lower urinary tract symptoms (LUTS) on watchful waiting (WW). METHOD Semi‐structured interviews with urologists, nurse practitioners and continence advisors were used to obtain a list of lifestyle and behavioural interventions used in men with LUTS. From the 18 interventions identified, a survey was constructed asking how often these interventions were used in routine practice. The survey was sent to 100 consultant urologists (British Association of Urological Surgeons), 100 nurse practitioners (British Association of Urological Nurses), and 100 continence advisors (International Continence Society) with an interest in male urology, all randomly selected. RESULTS Of 248 (83%) responses, 236 were suitable for analysis; 193 (82%) of the respondents reported using lifestyle or behavioural interventions in men on WW with uncomplicated LUTS. The most frequently used interventions were education about the prostate and bladder, avoiding caffeine, urethral milking and reassuring men that they do not have prostate cancer. The use of lifestyle and behavioural interventions showed an ‘all‐or‐none’ pattern. Respondents used either few or many of the 18 interventions identified. There was considerable variation in the extent to which these interventions were used among the survey groups ( P < 0.01); urologists used these interventions the least and continence advisors the most. CONCLUSIONS Lifestyle and behavioural interventions are advised by many medical professionals to men on WW with uncomplicated LUTS. However, the use varies considerably, with some medical professionals advising many of these interventions and some a few or none at all. Further research is required to define and test the effectiveness of these interventions in reducing LUTS.