RecommendationIf considering offering surgery for storage LUTS, refer men to a urologist to discuss:
  • the surgical and non-surgical options appropriate for their circumstances and
  • the potential benefits and limitations of each option, particularly long-term results
Trade off between clinical benefits and harmsThe benefits from a methodical approach to patient counselling as suggested are that unnecessary surgery will be much less likely, and so less harm will result from unnecessary surgery.
Economic considerationsReferring patients to a urologist has an opportunity cost but this is offset by the unnecessary interventions averted.
Other considerationsSurgery for storage symptoms requires very careful patient assessment and detailed counselling which must be based on individual experience rather than evidence reported from the literature in non randomised trials. Only those surgeons who have taken a particular interest in these patients and procedures are likely to have the range of experience necessary to meet these criteria. It is recommended that surgeons should participate in national audit of complex incontinence procedures.

From: 9, Surgery for men with storage symptoms

Cover of The Management of Lower Urinary Tract Symptoms in Men
The Management of Lower Urinary Tract Symptoms in Men [Internet].
NICE Clinical Guidelines, No. 97.
National Clinical Guideline Centre (UK).
Copyright © 2010, National Clinical Guideline Centre.

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