Lower urinary tract symptoms (LUTS) are common among Australian men.
Fewer than 20% of men aged under 45 years’ experience LUTS. Almost half of all men aged 65–79 years, and 70% of men aged 80 years or over, have LUTS1.
Many men endure LUTS in stoic silence due to feelings of embarrassment or shame, and ultimately present with complications including urinary retention, poor quality of life, mental health and relationship problems, or even advanced prostate cancer2.
Assessing a man’s urinary symptoms is very individualised and may be subjective. One man having to pass urine 3-4 times overnight might be a terrible night for some, whereas it could be a good night for others.
The International Prostate Symptom Score (IPSS) questionnaire is a validated tool for assessing LUTS3 that can be accessed online. The IPSS identifies how bothersome LUTS is to the man, which is a suitable indicator to gauge the actual concern of their symptoms.
Nurses in primary care are well positioned to assist with managing patients who present with urological issues by utilising validated tools like the IPSS and providing education about pharmaceutical or surgical treatment options. It is important for nurses to provide the most appropriate forms of education and information, or appropriate referral, to a patient based on their clinical and personal needs.
Tools and concepts from oncology care can be useful for helping support men with LUTS, even though very few men with LUTS will have prostate cancer.
Supportive health care embraces the full range of issues that emerge for an individual as the impact of diagnosis and treatment are felt and the person deals with their situation4. Applying the principle of supportive care to the management of men with LUTS can help to manage the symptoms and their impact on their lives.
A tool that can help nurses in primary care is the Distress Thermometer, a self-reported measure of physical, emotional, and social distress that is brief and non-invasive. The Distress Thermometer is a validated and acceptable alternative to longer psychometric instruments used for supportive care in cancer patients.
1 A practical approach to the management of lower urinary tract symptoms among men. Med J Aust 2011
2 The benefits of a shared-care prostate clinic. British Journal of Urology 1996
3 The american urological association symptom index for benign prostatic hyperplasia. The measurement committee of the american urological association. J Urol 1992
4 Supportive care for cancer patients. Hosp Q 2000