2019 surveillance of lower urinary tract symptoms in men:management (NICE guideline CG97)
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Surveillance proposal
We propose to not update the guideline on lower urinary tract symptoms in men: management.
The following table gives an overview of how evidence identified in surveillance might affect each area of the guideline.
Section of the guideline | New evidence identified | Impact |
1.1 Initial assessment | No | No |
1.2 Specialist assessment | Yes | No |
1.3 Conservative management | Yes | No |
1.4 Drug treatment | Yes | No |
1.5 Surgery for voiding symptoms | Yes | No |
1.6 Surgery for storage symptoms | Yes | No |
1.7 Treating urinary retention | No | No |
1.8 Alternative and complementary therapies | Yes | No |
1.9 Providing information | No | No |
Reasons for the proposal to not update the guideline
The new evidence was found to be broadly consistent with the current recommendations. We found new evidence on medical and surgical treatments including evidence on Urolift, Rezum and laser vaporisation for treatment of lower urinary tract symptoms (LUTS). These interventions are not included in the guideline but have been covered in other related NICE publications and incorporated in the NICE flowchart for 'Managing lower urinary tract symptoms in men':
Prostatic urethral temporary implant insertion for lower urinary tract symptoms caused by benign prostatic hyperplasia (2019) NICE interventional procedures guidance 641
Transurethral water jet ablation for lower urinary tract symptoms caused by benign prostatic hyperplasia (2018) NICE interventional procedures guidance 629
Transurethral water vapour ablation for lower urinary tract symptoms caused by benign prostatic hyperplasia (2018) NICE interventional procedures guidance 625
Prostate artery embolisation for lower urinary tract symptoms caused by benign prostatic hyperplasia (2018) NICE interventional procedures guidance 611
Rezum for treating benign prostatic hyperplasia (2018) NICE medtech innovation briefing 158
Axonics sacral neuromodulation system for overactive bladder and faecal incontinence (2018) NICE medtech innovation briefing 164
Memokath-028, 044 and 045 stents for urethral obstruction (2017) NICE medtech innovation briefing 123
Urethrotech UCD for difficult or failed catheterisation (2017) NICE medtech innovation briefing 116
S-Cath System for suprapubic catheterisation (2016) NICE medtech innovation briefing 68
BladderScan BVI 9400 3D portable ultrasound scanner for measuring bladder volume (2016) NICE medtech innovation briefing 50
GreenLight XPS for treating benign prostatic hyperplasia (2016) NICE medical technologies guidance 29
Sacral nerve stimulation for idiopathic chronic non-obstructive urinary retention (2015) NICE interventional procedures guidance 536
UroLift for treating lower urinary tract symptoms of benign prostatic hyperplasia (2015) NICE medical technologies guidance 26
The TURis system for transurethral resection of the prostate (2015) NICE medical technologies guidance 23
Insertion of prostatic urethral lift implants to treat lower urinary tract symptoms secondary to benign prostatic hyperplasia (2014) NICE interventional procedures guidance 475
Mirabegron for treating symptoms of overactive bladder (2013) NICE technology appraisal guidance 290
Lower urinary tract symptoms in men (2013) NICE quality standard 45
Lower urinary tract symptoms secondary to benign prostatic hyperplasia: tadalafil (2013) NICE evidence summary ESNM18
Percutaneous posterior tibial nerve stimulation for overactive bladder syndrome (2010) NICE interventional procedures guidance 362
Laparoscopic augmentation cystoplasty (including clam cystoplasty) (2009) NICE interventional procedures guidance 326
Laparoscopic prostatectomy for benign prostatic obstruction (2008) NICE interventional procedures guidance 275
Sacral nerve stimulation for urge incontinence and urgency-frequency (2004) NICE interventional procedures guidance 64
Holmium laser prostatectomy (2003) NICE interventional procedures guidance 17
Transurethral electrovaporisation of the prostate (2003) NICE interventional procedures guidance 14
For further details and a summary of all evidence identified in surveillance, see appendix A below.
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