Lower urinary tract symptoms in men: management

Reasons for the decision

This 2019 full surveillance review included 388 pieces of evidence identified from all surveillance reviews since guideline publication in 2010. Initial assessment suggested that the evidence was broadly consistent with the current recommendations. However, we found a large body of evidence on newer interventions and surgical treatments including Urolift, Rezum and laser vaporisation for treatment of voiding symptoms of the lower urinary tract, which are not addressed in the current guideline (see appendix A). Additionally, 2 of 3 topic experts suggested that the guideline needed updating, highlighting new surgical procedures. However, as some of these new procedures are covered in other NICE guidance and advice, and are incorporated in the NICE Pathway on lower urinary tract symptoms in men, we initially proposed that the guideline did not need to be updated. During consultation 5 of 6 stakeholders disagreed with this proposal and strongly felt that the guideline did not reflect current clinical practice as more treatment options including advances in technology and new surgical procedures have become available. In addition, a comprehensive single piece of guidance would be most useful for healthcare professionals. Therefore, the proposal was re-considered and it was decided that the guideline needs to be updated, concentrating on surgical treatment for voiding symptoms.

The current related pieces of NICE guidance are as follows:

For further details and a summary of all evidence identified in surveillance, see appendix A.