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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].

Referral for specialist assessment

  • The recommendations about referral for specialist assessment are based on expert opinion as NICE found no directly relevant clinical trials [NICE, 2010].

Assessing renal function with serum creatinine

  • The indications for measuring serum creatinine (palpable bladder, nocturnal enuresis, recurrent urinary tract infection, history of renal stones) are based on expert opinion, because NICE found no studies that assessed how measuring renal function affects clinical outcomes in men with lower urinary tract symptoms (LUTS) [NICE, 2010].
  • The NICE guideline development group considered serum creatinine to be the most reliable routine test for renal function. They highlighted that many laboratories report eGFR (estimated glomerular filtration rate) whenever serum creatinine is measured, and that (when required) renal function can be more accurately assessed by measuring creatinine clearance.
  • The NICE guideline development group considered serum urea to be less reliable than serum creatinine for assessing renal function.

Assessing renal function and structure with radiological imaging

  • The NICE systematic review found no studies that assessed how radiological imaging affects clinical outcomes in men with LUTS. The recommendations are therefore based on expert opinion [NICE, 2010].

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