Print Print
CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.

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].

Admission

  • The recommendations to admit men with acute urinary retention (unless the expertise and facilities are available in primary care) is based on expert opinion in NICE referral guidelines [NICE, 2001].

Alpha-blockers

  • The recommendation on offering an alpha-blocker before removal of the urinary catheter in an episode of acute retention reflects NICE guidelines [NICE, 2010].
    • The NICE systematic review found four randomized controlled trials (RCTs) that provide consistent, but imprecise because the studies were small, evidence that alpha-blockers improve the chance of being able to void after removing the urinary catheter. Two of the RCTs found no significant difference in the need for recatheterization, but the studies lacked statistical power and had serious methodological limitations. One economic study conducted in the UK suggests that the use of an alpha-blocker may be cost-saving, but the study did not include a full cost-effectiveness analysis.

Intermittent or continuous urethral catheterization

  • These recommendations are based on expert opinion, because NICE found no directly relevant controlled trials [NICE, 2010].

© NHS Institute for Innovation and Improvement