Prevalence of lower urinary tract symptoms and prostate enlargement in the primary care setting

Abstract Background Invasive urodynamics is used to investigate the causes of lower urinary tract symptoms; a procedure usually conducted in secondary care by specialist practitioners. No study has yet investigated the feasibility of carrying out this procedure in a non-specialist setting. Therefore, the aim of this study was to explore, using qualitative methodology, the feasibility and acceptability of conducting invasive urodynamic testing in primary care. Methods Semi-structured interviews were conducted during the pilot phase of the PriMUS study, in which men experiencing bothersome lower urinary tract symptoms underwent invasive urodynamic testing along with a series of simple index tests in a primary care setting. Interviewees were 25 patients invited to take part in the PriMUS study and 18 healthcare professionals involved in study delivery. Interviews were audio-recorded, transcribed verbatim and analysed using a framework approach. Results Patients generally found the urodynamic procedure acceptable and valued the primary care setting due to its increased accessibility and familiarity. Despite some logistical issues, facilitating invasive urodynamic testing in primary care was also a positive experience for urodynamic nurses. Initial issues with general practitioners receiving and utilising the results of urodynamic testing may have limited the potential benefit to some patients. Effective approaches to study recruitment included emphasising the benefits of the urodynamic test and maintaining contact with potential participants by telephone. Patients’ relationship with their general practitioner was an important influence on study participation. Conclusions Conducting invasive urodynamics in primary care is feasible and acceptable and has the potential to benefit patients. Facilitating study procedures in a familiar primary care setting can impact positively on research recruitment. However, it is vital that there is a support network for urodynamic nurses and expertise available to help interpret urodynamic results.

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Erectile dysfunction and lower urinary tract symptoms: prevalence and risk factors in a Hong Kong primary care setting

Hong Kong Medical Journal ◽

10.12809/hkmj133770 ◽

2013 ◽

Cited By ~ 1

Author(s):

KH Ngai ◽

Alfred SK Kwong ◽

Ann SK Wong ◽

Wendy WS Tsui

Keyword(s):

Risk Factors ◽

Primary Care ◽

Hong Kong ◽

Erectile Dysfunction ◽

Urinary Tract ◽

Lower Urinary Tract ◽

Care Setting ◽

Primary Care Setting ◽

Urinary Tract Symptoms ◽

Lower Urinary

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Noninvasive Management of Lower Urinary Tract Symptoms and Sexual Dysfunction Associated With Benign Prostatic Hyperplasia in the Primary Care Setting

Comprehensive Therapy ◽

10.1385/comp:31:3:194 ◽

2005 ◽

Vol 31 (3) ◽

pp. 194-208 ◽

Cited By ~ 1

Author(s):

Louis Kuritzky

Keyword(s):

Primary Care ◽

Urinary Tract ◽

Benign Prostatic Hyperplasia ◽

Sexual Dysfunction ◽

Lower Urinary Tract ◽

Care Setting ◽

Primary Care Setting ◽

Prostatic Hyperplasia ◽

Urinary Tract Symptoms ◽

Lower Urinary

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Urodynamic Evaluation in Diabetic Patients with Prostate Enlargement and Lower Urinary Tract Symptoms

Urologia Internationalis ◽

10.1159/000132695 ◽

2008 ◽

Vol 80 (4) ◽

pp. 378-382 ◽

Cited By ~ 7

Author(s):

Paulo Tadeu Dib ◽

Flavio Trigo-Rocha ◽

Cristiano Mendes Gomes ◽

Miguel Srougi

Keyword(s):

Urinary Tract ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

Diabetic Patients ◽

Urodynamic Evaluation ◽

Prostate Enlargement ◽

Urinary Tract Symptoms ◽

Lower Urinary

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Evaluation of the Effectiveness of Nurse-Led Continence Care Treatments for Chinese Primary Care Patients with Lower Urinary Tract Symptoms

PLoS ONE ◽

10.1371/journal.pone.0129875 ◽

2015 ◽

Vol 10 (6) ◽

pp. e0129875 ◽

Cited By ~ 8

Author(s):

Edmond P. H. Choi ◽

Weng-Yee Chin ◽

Cindy L. K. Lam ◽

Eric Y. F. Wan ◽

Anca K. C. Chan ◽

...

Keyword(s):

Primary Care ◽

Urinary Tract ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

Urinary Tract Symptoms ◽

Primary Care Patients ◽

Lower Urinary

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PRImary care Management of lower Urinary tract Symptoms in men: protocol for development and validation of a diagnostic and clinical decision support tool (the PriMUS study)

BMJ Open ◽

10.1136/bmjopen-2020-037634 ◽

2020 ◽

Vol 10 (6) ◽

pp. e037634

Author(s):

Bethan Pell ◽

Emma Thomas-Jones ◽

Alison Bray ◽

Ridhi Agarwal ◽

Haroon Ahmed ◽

...

Keyword(s):

Primary Care ◽

Urinary Tract ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

Decision Support Tool ◽

Clinical Decision ◽

Support Tool ◽

Urinary Tract Symptoms ◽

Primary Care Management ◽

Lower Urinary

IntroductionLower urinary tract symptoms (LUTS) is a bothersome condition affecting older men which can lead to poor quality of life. General practitioners (GPs) currently have no easily available assessment tools to help effectively diagnose causes of LUTS and aid discussion of treatment with patients. Men are frequently referred to urology specialists who often recommend treatments that could have been initiated in primary care. GP access to simple, accurate tests and clinician decision tools are needed to facilitate accurate and effective patient management of LUTS in primary care.Methods and analysisPRImary care Management of lower Urinary tract Symptoms (PriMUS) is a prospective diagnostic accuracy study based in primary care. The study will determine which of a number of index tests used in combination best predict three urodynamic observations in men who present to their GP with LUTS. These are detrusor overactivity, bladder outlet obstruction and/or detrusor underactivity. Two cohorts of participants, one for development of the prototype diagnostic tool and other for validation, will undergo a series of simple index tests and the invasive reference standard (invasive urodynamics). We will develop and validate three diagnostic prediction models based on each condition and then combine them with management recommendations to form a clinical decision support tool.Ethics and disseminationEthics approval is from the Wales Research Ethics Committee 6. Findings will be disseminated through peer-reviewed journals and conferences, and results will be of interest to professional and patient stakeholders.Trial registration numberISRCTN10327305.

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