Quality statement 8: Surgery for voiding symptoms

Quality statement

Men with voiding symptoms are offered surgery only if voiding symptoms are severe or if drug treatment and conservative management have been unsuccessful or are not appropriate.

Rationale

This quality statement aims to ensure the appropriate offer of surgery to men with voiding symptoms.

For some men with voiding symptoms, surgery can improve symptoms. But it should be offered only to men with severe symptoms or to men in whom drug treatment and conservative management have not worked. Men with mild or moderate symptoms should try other treatments before surgery. Men with severe symptoms are still eligible for drug treatment and conservative management.

Quality measures

Structure

Evidence of local arrangements to ensure that men with voiding symptoms are offered surgery only if voiding symptoms are severe or if drug treatment and conservative management have been unsuccessful or are not appropriate.

Data source: Local data collection.

Process

Proportion of men with voiding symptoms offered surgery whose symptoms are severe or in whom drug treatment and conservative management have been unsuccessful or are not appropriate.

Numerator – the number of men in the denominator who are offered surgery.

Denominator – the number of men with voiding symptoms whose symptoms are severe or in whom drug treatment and conservative management have been unsuccessful or are not appropriate.

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 offer surgery to men with voiding symptoms only if voiding symptoms are severe or if drug treatment and conservative management have been unsuccessful or are not appropriate.

Healthcare professionals offer surgery to men with voiding symptoms only if voiding symptoms are severe or if drug treatment and conservative management have been unsuccessful or are not appropriate.

Commissioners ensure that they commission services with local arrangements to offer surgery to men with voiding symptoms only if voiding symptoms are severe or if drug treatment and conservative management have been unsuccessful or are not appropriate.

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

Men with voiding symptoms (problems passing urine) are offered an operation only if voiding symptoms are severe or if drug treatment and other management options have been unsuccessful or are not appropriate.

Source guidance

Lower urinary tract symptoms (NICE clinical guideline 97), recommendation 1.5.1.

Definitions of terms used in this quality statement

Voiding symptoms

Voiding symptoms include weak or intermittent urinary stream, straining, hesitancy, terminal dribbling and incomplete emptying. The International Prostate Symptom Score (IPSS) categorises levels of severity. A score of 20–35 is for severe symptoms. A score of 8–19 is for moderate symptoms and a score of 0–8 is for mild symptoms.