Treatment Preferences of Patients With Benign Prostatic Hyperplasia Before and After Using a Web-based Decision Aid.

OBJECTIVE: To evaluate treatment preferences of patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) before and after using a web-based decision aid (DA). PATIENTS AND METHODS: Between July 2016 and January 2017 patients were invited to use a web-based LUTS/BPH DA. Treatment preferences (for lifestyle advices, medication or surgery) before and after DA use and responses on values clarification exercises were extracted from the DA. RESULTS: In total, 126 patients were included in the analysis. Thirty-four percent (43/126) had not received any previous treatment and were eligible for (continuation of) lifestyle advices or to start medication, as initial treatment. The other 66% (83/126) did use medication and were eligible, either for continuing medication or to undergo surgery. Before being exposed to the DA, 67 patients (53%) were undecided and 59 patients (47%) indicated an initial treatment preference. Half of the patients who were initially undecided were able to indicate a preference after DA use (34/67, 51%). Of those with an initial preference, 80% (47/59) confirmed their initial preference after DA use. Five out of 7 values clarification exercises used in the DA were discriminative between final treatment preferences. In 79%, the treatment preferred after DA use matched the received treatment. Overall, healthcare providers were positive about DA feasibility. CONCLUSION: Our findings suggest that a LUTS/BPH DA may help patients to confirm their initial treatment preference and support them in forming a treatment preference if they did not have an initial preference.

Uroflowmetry in healthy women: A systematic review.

BACKGROUND: Although uroflowmetry is a widely used diagnostic test, reference values of uroflowmetry parameters in women are lacking making it difficult to interpret the test results. AIM: To quantify the range of results in uroflowmetry parameters in healthy women based on a systematic review. METHODS: A search was made in the International Continence Society standardization articles, PubMed, Embase and the Cochrane Library (from inception to 27 February 2014). Studies on uroflowmetry in healthy women were included. The selected articles were examined using a critical appraisal process based on the QUADAS-2 tool and the Critical Appraisal Skills Program. RESULTS: Mean values of uroflowmetry parameters in healthy women (mean age 37.1 years) were: voided volume (VV) 338 ml (SD 161), maximum flow rate (Qmax) 23.5 ml/s (SD 10), average flow rate (Qave) 13 ml/s (SD 6), postvoid residual (PVR) 15.5 ml (SD 25), voiding time (VT) 29 sec (SD 17), and time to maximum flow rate (time to Qmax) 8 sec (SD 6). Qmax was dependent on VV. There was no clear relationship between Qmax and age, and no correlation between parity and Qmax. A normal shape of the uroflowmetry curve was seen in 70-80% of the flows. CONCLUSION: This systematic review provides an overview of the range of results of uroflowmetry parameters in healthy women. Neurourol. Urodynam. 36:953-959, 2017. © 2016 Wiley Periodicals, Inc.