The impact of self-management of lower urinary tract symptoms on frequency-volume chart measures

Abstract

Objective: To assess the effect of a self-management programme (SMP) on actual voiding behaviour using frequency-volume chart (FVC) data.

Patients and methods: In all, 140 men with uncomplicated lower urinary tract symptoms (LUTS) were recruited and randomised to either attend a SMP in addition to standard care, or standard care alone. The SMP group received three small group sessions that addressed behaviour and gave training in problem-solving strategies. Patients were assessed in urological clinics at baseline and 3, 6 and 12 months, completing the International Prostate Symptom Score (IPSS) and 3-day FVCs after assessment. Differences in voiding behaviour between the SMP and control groups were calculated analysed by intention-to-treat.

Results: Of the 140 patients, 104 completed the FVC data at baseline; at 3, 6 and 12 months charts were received from 99, 95 and 70, respectively. Baseline FVC variables were equivalent between the randomized groups. At 3 months the mean voided volume had increased in the SMP group and differed from the control group by a mean (95% confidence interval, CI) of 57 (33-83) mL. The total number of voids and episodes of nocturia were also lower in the SMP group, with a mean (95% CI) decrease of 2.6 (-3.6 to -1.5) and 0.7 (-1.1 to -0.3) episodes, respectively. These changes were maintained at 6 and 12 months.

Conclusion: A SMP in addition to standard care significantly improved the urinary symptoms of frequency and nocturia according to FVC monitoring. The exact mechanism of action and the specific interventions which affect this require further investigation.