![]() ![]() A SR and meta-analysis found reasonable certainty in estimates that self-management intervention significantly reduced symptom severity in terms of IPSS at six months compared with usual care. Men randomised to three self-care management sessions in addition to standard care had better symptom improvement and QoL than men treated with standard care only, for up to a year. providing necessary assistance when there is impairment of dexterity, mobility, or mental state Įvidence exists that self-management as part of WW reduces both symptoms and progression. reviewing the medication and optimising the time of administration or substituting drugs for others that have fewer urinary effects (these recommendations apply especially to diuretics) bladder retraining that encourages men to hold on when they have urgency to increase their bladder capacity and the time between voids distraction techniques such as penile squeeze, breathing exercises, perineal pressure, and mental tricks to take the mind off the bladder and toilet, to help control OAB symptoms urethral milking to prevent post-micturition dribble use of relaxed and double-voiding techniques avoidance/moderation of intake of caffeine or alcohol, which may have a diuretic and irritant effect, thereby increasing fluid output and enhancing frequency, urgency and nocturia reduction of fluid intake at specific times aimed at reducing urinary frequency when most inconvenient (e.g., at night or when going out in public) reassurance (that cancer is not a cause of the urinary symptoms).education (about the patient’s condition).It is customary for this type of management to include the following components: Men with mild-to-moderate uncomplicated LUTS who are not too troubled by their symptoms are suitable for WW. Increasing symptom bother and PVR volumes are the strongest predictors of WW failure. Ī study comparing WW and transurethral resection of the prostate (TURP) in men with moderate LUTS showed the surgical group had improved bladder function (flow rates and PVR volumes), especially in those with high levels of bother 36% of WW patients crossed over to surgery within five years, leaving 64% doing well in the WW group. ![]() In one study, approximately 85% of men with mild LUTS were stable on WW at one year. renal insufficiency or stones), whilst others can remain stable for years. Watchful waiting is a viable option for many men with non-bothersome LUTS as few will progress to AUR and complications (e.g. All men with LUTS should be formally assessed prior to any allocation of treatment in order to establish symptom severity and to differentiate between men with uncomplicated (the majority) and complicated LUTS. Many men with LUTS are not troubled enough by their symptoms to need drug treatment or surgical intervention. ![]()
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