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)

Amanda L. Lewis, Grace J. Young, Paul Abrams, Peter S. Blair, Christopher Chapple, Cathryn M.A. Glazener, Jeremy Horwood, John S. McGrath, Sian Noble, Gordon T. Taylor, Hiroki Ito, Mohammed Belal, Melissa C. Davies, Andrew J. Dickinson, Charlotte L. Foley, Steve Foley, Simon Fulford, Mohsen M. Gammal, Mary Garthwaite, Mark R.E. Harris & 23 others Petre C. Ilie, Robert Jones, Samer Sabbagh, Robert G. Mason, Ester McLarty, Vibhash Mishra, Jaswant Mom, Roland Morley, Salvatore Natale, Tharani Nitkunan, Tobias Page, David Payne, Tina G. Rashid, Kasra Saeb-Parsy, Sarb S. Sandhu, Adrian Simoes, Gurpreet Singh, Mark Sullivan, Heidi V. Tempest, Srinivasa Viswanath, Roger M.H. Walker, J. Athene Lane, Marcus J. Drake*

*Corresponding author for this work

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

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. Men being considered for surgery have additional clinical features that may affect treatment decision making and outcomes, notably storage lower urinary tract symptoms and impaired sexual function. Sociodemographic and clinical evaluations were similar between arms. The overall mean International Prostate Symptom Score and quality of life score were 18.94 and 4.13, respectively. Men undergoing urodynamic evaluation expressed high satisfaction with the procedure.

Original languageEnglish
Pages (from-to)340-350
Number of pages11
JournalEuropean Urology Focus
Volume5
Issue number3
Early online date30 Apr 2019
DOIs
Publication statusPublished - May 2019

Fingerprint

Lower Urinary Tract Symptoms
Urodynamics
Prostate
Nocturia
Psychological Stress
Hospital Urology Department
Decision Making
Therapeutics
Age Groups
Quality of Life
Patient Reported Outcome Measures
Secondary Care
Symptom Assessment
National Health Programs
Erectile Dysfunction
Random Allocation
Routine Diagnostic Tests
Urinary Bladder
Referral and Consultation
Randomized Controlled Trials

Keywords

  • Benign prostatic obstruction
  • Bladder outlet obstruction
  • Detrusor overactivity
  • Detrusor underactivity
  • Lower urinary tract symptoms
  • Patient-reported outcome measures
  • Prostate
  • Surgery
  • Underactive bladder
  • Urodynamics
  • STORAGE
  • LASER
  • PREVALENCE
  • HYPERPLASIA
  • PHOTOSELECTIVE VAPORIZATION
  • QUALITY-OF-LIFE
  • TRANSURETHRAL RESECTION

ASJC Scopus subject areas

  • Urology

Cite this

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) . / Lewis, Amanda L.; Young, Grace J.; Abrams, Paul; Blair, Peter S.; Chapple, Christopher; Glazener, Cathryn M.A.; Horwood, Jeremy; McGrath, John S.; Noble, Sian; Taylor, Gordon T.; Ito, Hiroki; Belal, Mohammed; Davies, Melissa C.; Dickinson, Andrew J.; Foley, Charlotte L.; Foley, Steve; Fulford, Simon; Gammal, Mohsen M.; Garthwaite, Mary; Harris, Mark R.E.; Ilie, Petre C.; Jones, Robert; Sabbagh, Samer; Mason, Robert G.; McLarty, Ester; Mishra, Vibhash; Mom, Jaswant; Morley, Roland; Natale, Salvatore; Nitkunan, Tharani; Page, Tobias; Payne, David; Rashid, Tina G.; Saeb-Parsy, Kasra; Sandhu, Sarb S.; Simoes, Adrian; Singh, Gurpreet; Sullivan, Mark; Tempest, Heidi V.; Viswanath, Srinivasa; Walker, Roger M.H.; Lane, J. Athene; Drake, Marcus J. (Corresponding Author).

In: European Urology Focus, Vol. 5, No. 3, 05.2019, p. 340-350.

Research output: Contribution to journalArticle

Lewis, AL, Young, GJ, Abrams, P, Blair, PS, Chapple, C, Glazener, CMA, Horwood, J, McGrath, JS, Noble, S, Taylor, GT, Ito, H, Belal, M, Davies, MC, Dickinson, AJ, Foley, CL, Foley, S, Fulford, S, Gammal, MM, Garthwaite, M, Harris, MRE, Ilie, PC, Jones, R, Sabbagh, S, Mason, RG, McLarty, E, Mishra, V, Mom, J, Morley, R, Natale, S, Nitkunan, T, Page, T, Payne, D, Rashid, TG, Saeb-Parsy, K, Sandhu, SS, Simoes, A, Singh, G, Sullivan, M, Tempest, HV, Viswanath, S, Walker, RMH, Lane, JA & Drake, MJ 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
Lewis, Amanda L. ; Young, Grace J. ; Abrams, Paul ; Blair, Peter S. ; Chapple, Christopher ; Glazener, Cathryn M.A. ; Horwood, Jeremy ; McGrath, John S. ; Noble, Sian ; Taylor, Gordon T. ; Ito, Hiroki ; Belal, Mohammed ; Davies, Melissa C. ; Dickinson, Andrew J. ; Foley, Charlotte L. ; Foley, Steve ; Fulford, Simon ; Gammal, Mohsen M. ; Garthwaite, Mary ; Harris, Mark R.E. ; Ilie, Petre C. ; Jones, Robert ; Sabbagh, Samer ; Mason, Robert G. ; McLarty, Ester ; Mishra, Vibhash ; Mom, Jaswant ; Morley, Roland ; Natale, Salvatore ; Nitkunan, Tharani ; Page, Tobias ; Payne, David ; Rashid, Tina G. ; Saeb-Parsy, Kasra ; Sandhu, Sarb S. ; Simoes, Adrian ; Singh, Gurpreet ; Sullivan, Mark ; Tempest, Heidi V. ; Viswanath, Srinivasa ; Walker, Roger M.H. ; Lane, J. Athene ; Drake, Marcus J. / 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) . In: European Urology Focus. 2019 ; Vol. 5, No. 3. pp. 340-350.
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title = "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)",
abstract = "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. Men being considered for surgery have additional clinical features that may affect treatment decision making and outcomes, notably storage lower urinary tract symptoms and impaired sexual function. Sociodemographic and clinical evaluations were similar between arms. The overall mean International Prostate Symptom Score and quality of life score were 18.94 and 4.13, respectively. Men undergoing urodynamic evaluation expressed high satisfaction with the procedure.",
keywords = "Benign prostatic obstruction, Bladder outlet obstruction, Detrusor overactivity, Detrusor underactivity, Lower urinary tract symptoms, Patient-reported outcome measures, Prostate, Surgery, Underactive bladder, Urodynamics, STORAGE, LASER, PREVALENCE, HYPERPLASIA, PHOTOSELECTIVE VAPORIZATION, QUALITY-OF-LIFE, TRANSURETHRAL RESECTION",
author = "Lewis, {Amanda L.} and Young, {Grace J.} and Paul Abrams and Blair, {Peter S.} and Christopher Chapple and Glazener, {Cathryn M.A.} and Jeremy Horwood and McGrath, {John S.} and Sian Noble and Taylor, {Gordon T.} and Hiroki Ito and Mohammed Belal and Davies, {Melissa C.} and Dickinson, {Andrew J.} and Foley, {Charlotte L.} and Steve Foley and Simon Fulford and Gammal, {Mohsen M.} and Mary Garthwaite and Harris, {Mark R.E.} and Ilie, {Petre C.} and Robert Jones and Samer Sabbagh and Mason, {Robert G.} and Ester McLarty and Vibhash Mishra and Jaswant Mom and Roland Morley and Salvatore Natale and Tharani Nitkunan and Tobias Page and David Payne and Rashid, {Tina G.} and Kasra Saeb-Parsy and Sandhu, {Sarb S.} and Adrian Simoes and Gurpreet Singh and Mark Sullivan and Tempest, {Heidi V.} and Srinivasa Viswanath and Walker, {Roger M.H.} and Lane, {J. Athene} and Drake, {Marcus J.}",
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doi = "10.1016/j.euf.2019.04.006",
language = "English",
volume = "5",
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TY - JOUR

T1 - Clinical and Patient-reported Outcome Measures in Men Referred for Consideration of Surgery to Treat Lower Urinary Tract Symptoms

T2 - Baseline Results and Diagnostic Findings of the Urodynamics for Prostate Surgery Trial; Randomised Evaluation of Assessment Methods (UPSTREAM)

AU - Lewis, Amanda L.

AU - Young, Grace J.

AU - Abrams, Paul

AU - Blair, Peter S.

AU - Chapple, Christopher

AU - Glazener, Cathryn M.A.

AU - Horwood, Jeremy

AU - McGrath, John S.

AU - Noble, Sian

AU - Taylor, Gordon T.

AU - Ito, Hiroki

AU - Belal, Mohammed

AU - Davies, Melissa C.

AU - Dickinson, Andrew J.

AU - Foley, Charlotte L.

AU - Foley, Steve

AU - Fulford, Simon

AU - Gammal, Mohsen M.

AU - Garthwaite, Mary

AU - Harris, Mark R.E.

AU - Ilie, Petre C.

AU - Jones, Robert

AU - Sabbagh, Samer

AU - Mason, Robert G.

AU - McLarty, Ester

AU - Mishra, Vibhash

AU - Mom, Jaswant

AU - Morley, Roland

AU - Natale, Salvatore

AU - Nitkunan, Tharani

AU - Page, Tobias

AU - Payne, David

AU - Rashid, Tina G.

AU - Saeb-Parsy, Kasra

AU - Sandhu, Sarb S.

AU - Simoes, Adrian

AU - Singh, Gurpreet

AU - Sullivan, Mark

AU - Tempest, Heidi V.

AU - Viswanath, Srinivasa

AU - Walker, Roger M.H.

AU - Lane, J. Athene

AU - Drake, Marcus J.

PY - 2019/5

Y1 - 2019/5

N2 - 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. Men being considered for surgery have additional clinical features that may affect treatment decision making and outcomes, notably storage lower urinary tract symptoms and impaired sexual function. Sociodemographic and clinical evaluations were similar between arms. The overall mean International Prostate Symptom Score and quality of life score were 18.94 and 4.13, respectively. Men undergoing urodynamic evaluation expressed high satisfaction with the procedure.

AB - 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. Men being considered for surgery have additional clinical features that may affect treatment decision making and outcomes, notably storage lower urinary tract symptoms and impaired sexual function. Sociodemographic and clinical evaluations were similar between arms. The overall mean International Prostate Symptom Score and quality of life score were 18.94 and 4.13, respectively. Men undergoing urodynamic evaluation expressed high satisfaction with the procedure.

KW - Benign prostatic obstruction

KW - Bladder outlet obstruction

KW - Detrusor overactivity

KW - Detrusor underactivity

KW - Lower urinary tract symptoms

KW - Patient-reported outcome measures

KW - Prostate

KW - Surgery

KW - Underactive bladder

KW - Urodynamics

KW - STORAGE

KW - LASER

KW - PREVALENCE

KW - HYPERPLASIA

KW - PHOTOSELECTIVE VAPORIZATION

KW - QUALITY-OF-LIFE

KW - TRANSURETHRAL RESECTION

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UR - http://www.mendeley.com/research/clinical-patientreported-outcome-measures-men-referred-consideration-surgery-treat-lower-urinary-tra

U2 - 10.1016/j.euf.2019.04.006

DO - 10.1016/j.euf.2019.04.006

M3 - Article

VL - 5

SP - 340

EP - 350

JO - European Urology Focus

JF - European Urology Focus

SN - 2405-4569

IS - 3

ER -