How are you taking part in this consultation?

You will not be able to change how you comment later.

You must be signed in to answer questions

  • Question on Consultation

    1. Do you agree with the proposal not to update the guideline?
    Please could let us know if you agree or disagree (yes/no) and provide with your comments regarding the same

  • Question on Consultation

    1. Do you have any comments on areas excluded from the scope of the guideline?
    Please could let us know if you agree or disagree (yes/no) and also provide with your comments regarding the same

  • Question on Consultation

    1. Do you have any comments on equalities issues?
    Please could let us know if you agree or disagree (yes/no) and also provide with your comments regarding the same
The content on this page is not current guidance and is only for the purposes of the consultation process.

2019 surveillance of lower urinary tract symptoms in men:management (NICE guideline CG97)

Closed for comments This consultation ended on at   Request commenting lead permission

Overview of 2019 surveillance methods

NICE's surveillance team checked whether recommendations in lower urinary tract symptoms in men: management (NICE guideline CG97) remain up to date.

The surveillance process consisted of:

  • Feedback from topic experts via a questionnaire.

  • A search for new or updated Cochrane reviews and national policy.

  • Consideration of evidence from previous surveillance.

  • Examining related NICE guidance and quality standards and NIHR signals.

  • A search for ongoing research.

  • Examining the NICE event tracker for relevant ongoing and published events.

  • Literature searches to identify relevant evidence.

  • Assessing the new evidence against current recommendations to determine whether or not to update sections of the guideline, or the whole guideline.

  • Consulting on the proposal with stakeholders (this document).

For further details about the process and the possible update decisions that are available, see ensuring that published guidelines are current and accurate in developing NICE guidelines: the manual.

Evidence considered in surveillance

Search and selection strategy

We searched for new evidence related to the whole guideline.

We found 166 studies in a search for randomised controlled trials and systematic reviews published between 15 November 2013 and 31 March 2019.

We also included:

  • 1 relevant study from a total of 11 studies identified by topic experts which was also identified through our search.

  • 222 studies identified by search in previous surveillance in 2012 and 2014.

From all sources, we considered 388 studies to be relevant to the guideline.

See appendix A below for details of all evidence considered, and references.

Ongoing research

We checked for relevant ongoing research; of the ongoing studies identified, 6 studies were assessed as having the potential to change recommendations. Therefore, we plan to check the publication status regularly and evaluate the impact of the results on current recommendations as quickly as possible. These studies are:

Intelligence gathered during surveillance

Views of topic experts

We considered the views of topic experts who were recruited to the NICE Centre for Guidelines Expert Advisers Panel to represent their specialty. For this surveillance review, topic experts completed a questionnaire about developments in evidence, policy and services related to the guideline.

We sent questionnaires to 7 topic experts and received 3 responses.

Key points highlighted in topic expert feedback included:

  • Inclusion of the new treatment modalities like Urolift, Rezum, laser vapourisation of the prostate (green light) and prostate artery embolisation in the NICE flowchart for LUTS

  • Stating superiority of HoLEP (Holmium Laser Enucleation of the Prostate) over TURP (Transurethral Resection of the Prostate) in the guideline

  • Superiority of HoLEP for prostates of any size compared to open prostatectomy

  • Replacement of Urolift with chronic drug therapy in treatment of LUTS

  • Insufficient warning about the potential for cognitive decline with antimuscarinic drugs in the guideline

  • Inclusion of combination therapy with solifenacin and mirabegron in the guideline.

Views of stakeholders

Stakeholders are consulted on all surveillance reviews except if the whole guideline will be updated and replaced. Because this surveillance proposal is to not update the guideline, we are consulting with stakeholders.

See ensuring that published guidelines are current and accurate in developing NICE guidelines: the manual for more details on our consultation processes.

Equalities

No equalities issues were identified during the surveillance process.

Editorial amendments

During surveillance of the guideline we identified the following issues with the NICE version of the guidelines that should be corrected:

Overall surveillance proposal

After considering all evidence and other intelligence and the impact on current recommendations, we propose that no update is necessary.