Clinical and Patient-reported Outcome Measures in Men Referred for Consideration of Surgery to Treat Lower Urinary Tract Symptoms:Baseline Results and Diagnostic Findings of the Urodynamics for Prostate Surgery Trial; Randomised Evaluation of Assessment Methods (UPSTREAM)
| Autor: | Hiroki Ito, Robert G. Mason, John S. McGrath, David Payne, Sarb Sandhu, Kasra Saeb-Parsy, Jeremy Horwood, Mark Sullivan, Melissa C Davies, Adrian Simoes, Gurpreet Singh, Paul Abrams, Christopher R. Chapple, Ester McLarty, Cathryn Glazener, Mohammed Belal, Mohsen M. Gammal, Samer Sabbagh, Roger Walker, Petre Cristian Ilie, Charlotte Foley, Tina Rashid, Gordon T. Taylor, Sian Noble, Steve Foley, Tobias Page, Jaswant Mom, Srinivasa Viswanath, Salvatore Natale, Peter S Blair, Andrew J. Dickinson, Simon Fulford, Heidi V. Tempest, J. Athene Lane, Amanda L. Lewis, Marcus J. Drake, Mark Harris, Grace J. Young, Robert Jones, Mary Garthwaite, Tharani Nitkunan, Vibhash Mishra, Roland Morley |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
030232 urology & nephrology law.invention 0302 clinical medicine Randomized controlled trial Quality of life law Surveys and Questionnaires Detrusor overactivity Penile Erection Age Factors Prostate Middle Aged UPSTREAM Patient Satisfaction Centre for Surgical Research 030220 oncology & carcinogenesis Patient-reported outcome International Prostate Symptom Score BRTC medicine.symptom Benign prostatic obstruction Bristol Population Health Science Institute medicine.medical_specialty Urology Bladder outlet obstruction Underactive bladder BTC (Bristol Trials Centre) 03 medical and health sciences Lower Urinary Tract Symptoms Lower urinary tract symptoms medicine Nocturia Humans Patient Reported Outcome Measures Aged Prostatectomy business.industry medicine.disease Detrusor underactivity Patient reported outcome measures Surgery Urodynamics Prostate surgery Sexual function business |
| Zdroj: | Lewis, A L, Young, G J, Abrams, P, Blair, P S, Chapple, C, Glazener, C M A, Horwood, J, McGrath, J S, Noble, S, Taylor, G T, Ito, H, Belal, M, Davies, M C, Dickinson, A J, Foley, C L, Foley, S, Fulford, S, Gammal, M M, Garthwaite, M, Harris, M R E, Ilie, P C, Jones, R, Sabbagh, S, Mason, R G, McLarty, E, Mishra, V, Mom, J, Morley, R, Natale, S, Nitkunan, T, Page, T, Payne, D, Rashid, T G, Saeb-Parsy, K, Sandhu, S S, Simoes, A, Singh, G, Sullivan, M, Tempest, H V, Viswanath, S, Walker, R M H, Lane, J A & Drake, M J 2019, ' Clinical and Patient-reported Outcome Measures in Men Referred for Consideration of Surgery to Treat Lower Urinary Tract Symptoms : Baseline Results and Diagnostic Findings of the Urodynamics for Prostate Surgery Trial; Randomised Evaluation of Assessment Methods (UPSTREAM) ', European Urology Focus, vol. 5, no. 3, pp. 340-350 . https://doi.org/10.1016/j.euf.2019.04.006 |
| Popis: | Background Clinical evaluation of male lower urinary tract symptoms (MLUTS) in secondary care uses a range of assessments. It is unknown how MLUTS evaluation influences outcome of therapy recommendations and choice, notably urodynamics (UDS; filling cystometry and pressure flow studies). Objective To report participants’ sociodemographic and clinical characteristics, and initial diagnostic findings of the Urodynamics for Prostate Surgery Trial; Randomised Evaluation of Assessment Methods (UPSTREAM). UPSTREAM is a randomised controlled trial evaluating whether symptoms are noninferior and surgery rates are lower if UDS is included. Design, setting, and participants A total of 820 men (≥18 yr of age) seeking treatment for bothersome LUTS were recruited from 26 National Health Service hospital urology departments. Intervention Care pathway based on routine, noninvasive tests (control) or routine care plus UDS (intervention arm). Outcome measurements and statistical analysis The primary outcome is International Prostate Symptom Score (IPSS) and the key secondary outcome is surgery rates 18 mo after randomisation. International Consultation on Incontinence Questionnaires were captured for MLUTS, sexual function, and UDS satisfaction. Baseline clinical and patient-reported outcome measures (PROMs), and UDS findings were informally compared between arms. Trends across age groups for urinary and sexual PROMs were evaluated with a Cuzick’s test, and questionnaire items were compared using Pearson’s correlation coefficient. Results and limitations Storage LUTS, notably nocturia, and impaired sexual function are prominent in men being assessed for surgery. Sociodemographic and clinical evaluations were similar between arms. Overall mean IPSS and quality of life scores were 18.94 and 4.13, respectively. Trends were found across age groups, with older men suffering from higher rates of incontinence, nocturia, and erectile dysfunction, and younger men suffering from increased daytime frequency and voiding symptoms. Men undergoing UDS testing expressed high satisfaction with the procedure. Conclusions Men being considered for surgery have additional clinical features that may affect treatment decision making and outcomes, notably storage LUTS and impaired sexual function. Patient summary We describe initial assessment findings from a large clinical study of the treatment pathway for men suffering with bothersome urinary symptoms who were referred to hospital for further treatment, potentially including surgery. We report the patient characteristics and diagnostic test results, including symptom questionnaires, bladder diaries, flow rate tests, and urodynamics. |
| Databáze: | OpenAIRE |
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