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NICE Clinical Guidelines 2010: The management of lower urinary tract symptoms in menNICE National Institute for Health and Clinical Excellence
NICE National Institute for Health and Clinical Excellence
All NICE Guidelines are designed and funded to support the NHS in the UK and have no formal jurisdiction outside of this territory
This is a very important and exhaustive Guideline which reviews a number of important aspects of the management of male LUTS, as: diagnostic tests available for evaluation and identification of underlying pathophysiology; the role of the conservative and lifestyle measures; pharmacotherapy, considering pharmacological agents as monotherapy or in combination; minimally invasive procedures and other surgical options. The Guidelines covers men (18 and over) with a clinical working diagnosis of LUTS but does not cover women. One of the most important aspects of this Guideline is that conservative, pharmacological, surgical, and complementary or alternative treatments are considered in terms of clinical and cost effectiveness. Indeed, the economic profile has been used to present cost and cost-effectiveness estimates from published studies or analyses conducted for the Guidelines. The NICE Guidelines also produced recommendations for each individual diagnostic measure and treatment modality for LUTS in men. With regards to Nocturia, the most important message is the consideration of the reduced frequency of night time voiding due to nocturnal polyuria as the most important outcome, which could have significant impact on patient’s sleep quality and quality of life. In addition, the NICE Guidelines “consider to offer oral desmopressin to men with nocturnal polyuria if other medical causes have been exhausted and they have not benefited from other treatments”.