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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].
Providing information on stress urinary incontinence and self-help resources
- The recommendation to provide information is based on expert opinion [NICE, 2010].
Referral for stress urinary incontinence not caused by prostatectomy
- The recommendation to provide information is based on expert opinion [NICE, 2010].
Use of urine containment products
- The recommendations about offering urinary containment products are based on expert opinion [NICE, 2010].
Pelvic floor muscle training
- NICE found 11 relevant randomized controlled trials of pelvic floor muscle training [NICE, 2010]. The data may be unreliable because the studies had limitations in design and precision (size of study), and the results lacked consistency and directness of applicability. Nevertheless, NICE found evidence that pelvic floor muscle training for stress incontinence after prostatectomy:
- Did not reduce incontinence rates in the first 3 months after prostatectomy.
- Reduced incontinence rates between 4–12 months after prostatectomy.
Treatments not recommended
- Penile clamps are not recommended for men with urinary incontinence. This is based on the expert opinion of the NICE guideline development group [NICE, 2010].
- Electrical stimulation is not recommended because NICE found no reliable evidence that it is effective [NICE, 2010].
Secondary care treatments
- The information on treatments recommended as options in secondary care is from the NICE guidelines on lower urinary tract symptoms, where the evidence is reviewed [NICE, 2010].
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