Self management for men with lower urinary tract symptoms: randomised controlled trial

Brown, Christian; Yap, Tet; Cromwell, David; Rixon, Lorna; Steed, Liz; Mulligan, Kathleen; Mundy, Anthony R.; Newman, Stanton; Meulen, Jan van der; Emberton, Mark

doi:10.1136/bmj.39010.551319.ae

Cited by 118 publications

(108 citation statements)

References 9 publications

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“…To uključuje i edukaciju pacijenata o njihovom stanju (naglasiti učestalost BPH-a te da uzrok smetnjama nije karcinom), periodičke kontrole (u pravilu jednom godišnje) i promjene stila življenja. Promjene stila življenja uključuju: -redukciju unosa tekućine u određeno vrijeme s ciljem smanjenja učestalosti mokrenja kada ono nije primjereno (primjerice prije odlaska na javno mjesto ili navečer kako bi se smanjila nikturija), -izbjegavanje ili umjereni unos pića s kofeinom ili alkoholom jer ono ima diuretski i/ili podražujući efekt te njihovo konzumiranje dovodi do povećanja količine izlučene mokraće, učestalo-sti mokrenja, urgencije i nikturije, -korištenje određenih relaksacijskih tehnika i mokrenja u dva vremena, -"iscjeđivanje mokraće" poput mužnje kako bi se spriječilo kapanje urina nakon završetka mokrenja, -korištenje distrakcijskih tehnika poput stiskanja penisa, vježbi disanja, pritiska na perineum i mentalnih trikova kako bi se smanjila pomisao na potrebu za mokrenjem, a sve kako bi se učinkovitije kontrolirale smetnje mokrenja, -"trening mjehura" kako bi se pacijenti potakli da zadrže mokraću unatoč urgenciji, a kako bi se povećao kapacitet mjehura i vrijeme između mokrenja, -usklađivanje lijekova i optimiziranje vremena njihova uzimanja ili zamjene s drugim lijekovima koji imaju manji učinak na mokraćni sustav (ovo se posebice odnosi na diuretike), -osiguravanje pomoći ljudima koji su slabije pokretni ili imaju smanjeni mentalni kapacitet, -liječenje konstipacije [19][20][21][22] . Promjene stila življenja su relativno jednostavna mjera koja može imati jako dobar i dugotrajan uči-nak.…”

Section: Liječenjeunclassified

Benign prostatc hyperplasia – medicamentous treatment

et al. 2017

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Sažetak. Benigna hiperplazija prostate (BPH) karakterizirana je umnažanjem žljezdanih i/ili stromalnih elemenata prostate. Ona može dovesti do uvećanja prostate i uzrokovati smetnje mokrenja donjeg dijela mokraćnog sustava (LUTS). Rast prostate ovisan je o dobi i utjecaju spolnih hormona, prvenstveno dihidrotestosterona. Simptomi se dijele na iritativne, opstruktivne i postmikcijske. U osnovnu obradu pacijenata spada anamneza, korištenje upitnika o smetnjama mokrenja, dnevnik mokrenja, fizikalni pregled, analiza urina, serumska koncentracija kreatinina i prostata specifičnog antigena, mikciometrija i mjerenje rezidualnog urina. Terapiju se odabire na osnovi smetnji koje pacijent ima i rezultata dijagnostičke obrade. Prvi korak u liječenju predstavljaju određene promjene u ponašanju i prehrani. U pacijenata s blagim smetnjama preporučuje se aktivno praćenje. U ostalih pacijenata započinje se s medikamentoznom terapijom. Mogućnosti medikamentozne terapije su mnogobrojne: blokatori alfa adrenergičkih receptora, inhibitori 5-alfa-reduktaze, antagonisti muskarinskih receptora, analog vazopresina -dezmopresin, agonisti beta-3 adrenergičkih receptora, inhibitori 5-fosfodiesteraze, fitoterapija i kombinirana terapija. U slučaju neuspjeha medikamentozne terapije ili prisutnosti komplikacija BPH-a preporučuje se kirurško liječenje.Ključne riječi: benigna hiperplazija prostate; medikamentozna terapija; simptomi donjeg mokraćnog sustava Abstract. Benign prostatic hyperplasia (BPH) is characterized with proliferation of glandular and stromal components of the prostate. BPH can produce prostate enlargement and caused lower urinary tract symptoms (LUTS). The growth of the prostate depends on patient's age and influence of sexual hormones, specially dihydrotestosterone. Symptoms can be divided as irritative, obstructive and postmicturation symptoms. The basic evaluation included medical history, symptom score questionnaire, bladder diary, physical examination, urinalysis, creatinine and prostate specific antigen serum concentration, uroflowmetry and postvoid residual urine. The modality of treatment depends about patients symptoms and results of diagnostic evaluation. The initial step in the treatment are behavioural and dietary modifications. In the patients with mild symptoms watchful waiting is first line treatment. In the other patients medicamentous treatment is recommended. Pharmacological management included: alpha adrenoreceptor antagonists, 5-alpha-reductase inhibitors, muscarin receptors antagonists, vasopressin analoguedesmopressin, beta-3 agonists, phosphodiesterase 5 inhibitors, phytotherapy and combination therapy. If the medicamentous therapy failed or the complications of BPH are present surgical treatment is recommended.

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Section: Liječenjeunclassified

Benign prostatc hyperplasia – medicamentous treatment

et al. 2017

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“…Two studies targeted older adults: community dwelling 80 and in residential care. 94 Two studies were specific to women participating in a programme of PFMT for SUI; 79,92,110 the remaining studies included people with mixed types of UI.…”

Section: Participantsmentioning

confidence: 99%

“…One excluded trial of mixed behavioural strategies does include men, but does not provide data on incontinence. 110 In the absence of any data from the review, we may need to refer back to the literature on the use of conservative methods for UI after prostatectomy for intervention type, timing and intensity to be used with men.…”

Section: Implications For Researchmentioning

confidence: 99%

Identifying Continence OptioNs after Stroke (ICONS): an evidence synthesis, case study and exploratory cluster randomised controlled trial of the introduction of a systematic voiding programme for patients with urinary incontinence after stroke in secondary care

Thomas

French

Sutton

et al. 2015

Programme Grants for Applied Research

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et al (2015) Identifying Continence OptioNs after Stroke (ICONS): an evidence synthesis, case study and exploratory cluster randomised controlled trial of the introduction of a systematic voiding programme for patients with urinary incontinence after stroke in secondary care. Programme Grants for Applied Research, 3 (1).It is advisable to refer to the publisher's version if you intend to cite from the work.http://dx.doi.org/10.3310/pgfar03010For more information about UCLan's research in this area go to http://www.uclan.ac.uk/researchgroups/ and search for . This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0707-10059. The contractual start date was in October 2008. The final report began editorial review in September 2013 and was accepted for publication in July 2014. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report. Published by the NI...

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“…In een gerandomiseerde studie in de urologische praktijk werd een zelfmanagementprogramma onderzocht voor de behandeling van plasklachten [8]. Dit programma was tot stand gekomen na gestructureerde consultatie van urologen, huisartsen en continentieverpleegkundigen.…”

Section: Leefstijladviezenunclassified

Mictieklachten bij mannen – meer dan een vergrote prostaat

Blanker¹,

Dekker²

2015

Bijblijven

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Plasklachten zijn bij mannen decennialang ten onrechte toegeschreven aan prostaatvergroting en daardoor ontstane urine-uitstroombelemmering. In deze bijdrage wordt de multifactoriële oorzaak van plasklachten toegelicht, met specifieke aandacht voor de rol van de bekkenbodem. Uitleg over het onschuldige karakter en het gunstig beloop van plasklachten zijn naast leefstijladviezen de eerste stap in het behandelplan. De onderbouwing daarvan is beperkt. Dat geldt ook voor het effect van bekkenfysiotherapie bij mannen met plasklachten. InleidingPlasklachten komen vaak voor bij de ouder wordende man en werden voorheen toegeschreven aan goedaardige prostaatvergroting. In de afgelopen decennia zijn de inzichten rond het ontstaan van plasklachten bij mannen veranderd. Prostaatvergroting speelt daarin een veel kleinere rol. In deze bijdrage worden hypothesen over de pathofysiologie van plasklachten bij mannen toegelicht, gevolgd door de fysiologie van de mictie op bekkenniveau, met bijzondere aandacht voor de rol van de bekkenbodemspieren. Er wordt kort stilgestaan bij de diagnostiek door de huisarts. Daarna worden het natuurlijk beloop en de niet-medicamenteuze behandeling besproken, gevolgd door de overige therapeutische opties die de huisarts voor deze grote patiëntengroep heeft.

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Self management for men with lower urinary tract symptoms: randomised controlled trial

Cited by 118 publications

References 9 publications

Benign prostatc hyperplasia – medicamentous treatment

Benign prostatc hyperplasia – medicamentous treatment

Identifying Continence OptioNs after Stroke (ICONS): an evidence synthesis, case study and exploratory cluster randomised controlled trial of the introduction of a systematic voiding programme for patients with urinary incontinence after stroke in secondary care

Mictieklachten bij mannen – meer dan een vergrote prostaat

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