Quality statement 2: Initial assessment – urinary frequency and volume chart

Quality statement

Men with bothersome lower urinary tract symptoms (LUTS) are asked to complete a urinary frequency and volume chart, as part of their initial assessment.

Rationale

Urinary frequency and volume charts add important information to the medical history. They can also help the healthcare professional to make an accurate diagnosis and to distinguish nocturnal polyuria (greater than a third of daily urine output during the night) from detrusor overactivity (normal urine production but increased urinary frequency with urgency and small volumes of urine passed each time).

Quality measures

Structure

Evidence of local arrangements to ensure that men with bothersome LUTS are asked to complete a urinary frequency and volume chart, as part of their initial assessment.

Data source: Local data collection.

Process

Proportion of men with bothersome LUTS who complete a urinary frequency and volume chart, as part of their initial assessment.

Numerator – the number of men in the denominator who complete a urinary frequency and volume chart, as part of their initial assessment.

Denominator – the number of men who present with bothersome LUTS.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers ensure that local arrangements are in place to ask men with bothersome LUTS to complete a urinary frequency and volume chart, as part of their initial assessment.

Healthcare professionals ensure that they ask men with bothersome LUTS to complete a urinary frequency and volume chart, as part of their initial assessment.

Commissioners ensure that they commission services with local arrangements to ask men with bothersome LUTS to complete a urinary frequency and volume chart, as part of their initial assessment.

What the quality statement means for patients, service users and carers

Men with bothersome LUTS are asked, as part of their initial assessment, to record how often they pass urine and the amount of urine passed.

Source guidance

  • Lower urinary tract symptoms (NICE clinical guideline 97), recommendation 1.1.3 (key priority for implementation).

Definitions of terms used in this quality statement

Bothersome LUTS

Bothersome LUTS are symptoms at presentation that are worrying, troublesome or have an impact on a man's quality of life. These may vary based on the individual man's circumstances. This quality statement does not cover men who may present seeking reassurance related only to concerns about the risk of prostate cancer.

A urinary frequency and volume chart

A simple, non-invasive tool used as part of the initial assessment of men presenting with LUTS. A urinary frequency and volume chart records voided volumes and times of voiding (day and night) for at least 3 days.

Initial assessment

Initial assessment refers to the first assessment within the assessment process, carried out in any setting by a healthcare professional without specific training in managing LUTS in men. Initial assessment may involve a range of assessments as outlined in NICE clinical guideline 97 depending on the presenting symptoms. Based on expert consensus, the initial assessment may involve more than 1 consultation but normally no more than 3 consultations.

Equality and diversity considerations

All information about the urinary frequency and volume chart should be accessible to men with additional needs such as physical, sensory or learning disabilities, and to people who do not speak or read English. Men receiving information should have access to an interpreter or advocate if needed.

Men who have physical, sensory or cognitive impairment may need help to complete the chart. If possible, carers should be instructed in how they can help to complete the chart.

Men should be provided with information that reflects any religious, ethnic, transgender or cultural needs.