The impact of self‐management of lower urinary tract symptoms on frequency‐volume chart measures

Abstract

Prostate Symptom Score (IPSS) and 3-day FVCs after assessment. Differences in voiding behaviour between the SMP and control groups were calculated analysed by intention-to-treat. RESULTSOf the 140 patients, 104 completed the FVC data at baseline; at 3, 6 and 12 months charts were received from 99, 95 and 70, respectively. Baseline FVC variables were equivalent between the randomized groups. At 3 months the mean voided volume had increased in the SMP group and differed from the control group by a mean (95% confidence interval, CI) of 57 (33-83) mL. The total number of voids and episodes of nocturia were also lower in the SMP group, with a mean (95% CI) decrease of 2.6 ( − 3.6 to − 1.5) and 0.7 ( − 1.1 to − 0.3) episodes, respectively. These changes were maintained at 6 and 12 months. CONCLUSIONA SMP in addition to standard care significantly improved the urinary symptoms of frequency and nocturia according to FVC monitoring. The exact mechanism of action and the specific interventions which affect this require further investigation. KEYWORDSself-management, frequency-volume chart, benign prostatic hyperplasia, lower urinary tract symptoms OBJECTIVETo assess the effect of a self-management programme (SMP) on actual voiding behaviour using frequency-volume chart (FVC) data. PATIENTS AND METHODSIn all, 140 men with uncomplicated lower urinary tract symptoms (LUTS) were recruited and randomised to either attend a SMP in addition to standard care, or standard care alone. The SMP group received three small group sessions that addressed behaviour and gave training in problemsolving strategies. Patients were assessed in urological clinics at baseline and 3, 6 and 12 months, completing the International

The optimal duration of frequency‐volume charts related to compliance and reliability

“…The “true frequency” is still based on patient report, by recording coded letters. Mean urine production, however, is comparable with other studies . Other types of voiding diaries that include urgency scales or fluid intake, might show different compliance rates.…”

Nocturia as a manifestation of systemic disease

“…Likewise, nocturia response to diuretic therapy is partly predicted by alterations in baseline ANP levels [67]. The presence of NP reduces the prospect of nocturia improvement in response to antimuscarinic drugs [68]. Evaluation of treatment response requires objective data to corroborate subjective impressions; a FVC before and during treatment allows greater sensitivity when evaluating treatment response, and facilitates self‐management [69].…”

Development of an online personalized self‐management intervention for men with uncomplicated LUTS

“…26 The opinions of physicians may also reflect their wish to involve patients in treatment, viewing lifestyle advice as a harmless means of achieving this goal. Supporting this position, and consistent with their use in many multicomponent intervention studies, 4,[21][22][23][24][25]27 physicians strongly agreed with the inclusion of most of the advice items. In particular, they agreed that general information and education about LUTS should be included for all patients, together with advice about caffeine use, alcohol use, and exercise.…”

“…Among the available randomized controlled trials, five had analyzed specific advice, [16][17][18][19][20] and five had analyzed multicomponent selfmanagement and lifestyle interventions. 4,[21][22][23][24][25] Consistent with the main guidelines in this field, 1-3,9-15 the physicians we queried considered most of the advice we included to be relevant for patients and supported its inclusion in the intervention.…”