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Lower urinary tract symptoms in men, age-related (including symptoms of benign prostatic hyperplasia/hypertrophy) - Management
Basis for recommendation

These recommendations are in line with the guideline The management of lower urinary tract symptoms in men from the National Institute for Health and Clinical Excellence (NICE) [NICE, 2010].

Supervised bladder training, advice on fluid intake, lifestyle advice, containment products

  • The recommendations on supervised bladder training, advice on fluid intake, lifestyle advice, and containment products are based on expert opinion, as NICE found no relevant clinical or economic studies [NICE, 2010].

Antimuscarinics (anticholinergics)

  • The recommendation to consider using an antimuscarinic for overactive bladder symptoms is based on expert opinion. The best trial-based evidence is from one small randomized controlled trial, which reported the data graphically and without statistical analysis [NICE, 2010].
    • Anticholinergics reduced the number of urinary incontinence episodes compared with placebo (but not compared with alpha-blockers). There were no other improvements noted compared with placebo. Reduction in the number of incontinence episodes is an important benefit.
    • Minor adverse effects (such as dry mouth) are common. Urinary retention is a serious possible adverse effect, but NICE found no evidence that this risk is clinically important.
    • The recommendations on follow up and monitoring are based on expert opinion, as NICE found no relevant clinical trials.

Secondary care treatments

  • The information on treatments used in secondary care is from the NICE guidance [NICE, 2010].

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