NICE's quality standard on lower urinary tract symptoms (LUTS) highlights the need for greater awareness of the initial assessment and management of the condition.
The risk of bothersome symptoms associated with the lower urinary tract tends to increase with age, with nearly a third of men over the age of 65 having some form of symptoms.
The three most common types of symptoms associated with the condition are storage, voiding, and post-micturition symptoms that affect the lower urinary tract.
While LUTS do not usually cause severe illness, they can considerably reduce a man's quality of life, and may indicate serious underlying pathology of the urogenital tract.
To help GPs and other healthcare professionals ensure men with LUTS get the best quality of care, NICE has produced a quality standard which includes 8 quality statements to support the measurable improvement of services.
These include a statement which says that men with LUTS should be offered a full physical examination, which includes a digital rectal examination, as part of their initial assessment.
NICE says that it is important to carry out a full physical examination so that abnormalities of the abdomen and external genitalia are not missed and left untreated.
Performing a digital rectal examination is essential to assess the size of the prostate and to detect abnormalities that might indicate malignancy. It is also good practice to identify abnormalities, such as prostatitis (inflammation of the prostate) and associated conditions, which might affect bladder function.
Another statement calls for men with bothersome LUTS to be asked to complete a urinary frequency and volume chart as part of their initial assessment. This can help with making an accurate diagnosis and help distinguish nocturnal polyuria from detrusor overactivity.
Further statements cover conservative management, and suggest that men with LUTS who have urinary incontinence should be offered a choice of temporary containment products such as pads or collecting devices as part of their initial assessment.
NICE says such products help manage incontinence, offer security and comfort, and help men to continue their normal daily activities, including social activities, and therefore improve quality of life.
All of NICE's recommendations and associated implementation tools on LUTS can be found in the associatedNICE pathway.