News - June 2010

Contents
Guidance released on management of lower urinary tract symptoms in men Advice published on alcohol-use disorders Recommendations in NICE skin cancer guideline updated News in brief - SIGN has updated its guideline on stroke rehabilitation News in brief - A guideline on constipation in children and young people has been published by NICE

Guidance released on management of lower urinary tract symptoms in men

Nearly one in three UK men over the age of 50 years of age have urinating problems, which many mistakenly accept as a normal part of getting old, or feel too embarrassed to seek help from their GP. Men with lower urinary tract symptoms (LUTS) often find they have to visit the toilet often and urgently, and have to strain to urinate.

NICE has released Lower urinary tract symptoms: The management of lower urinary tract symptoms in men to assist healthcare professionals to diagnose, monitor, and treat this condition.

Lower urinary tract symptoms refer to storage, voiding, and post-micturition symptoms affecting the lower urinary tract. Conditions that can cause LUTS, include:

benign prostate enlargement
detrusor muscle weakness or overactivity
prostate inflammation
urinary tract infection
prostate cancer
neurological disease.

The new guideline from NICE will aim to clear up the uncertainty and variation that exists in clinical practice. The guideline recommendations cover:

initial assessment
specialist assessment
conservative management
drug treatment
surgery for voiding and storage symptoms
treating urinary retention.

To support the implementation of this guideline, a number of support documents have been produced, including a baseline assessment tool and implementation briefing documents for both GPs and pharmacists. NICE has also produced Understanding NICE guidance—lower urinary tract symptoms for patients and their families/carers. It includes details of patient support groups that can offer help and advice.

www.nice.org.uk

Advice published on alcohol-use disorders

It is estimated that 24% of UK adults drink in a hazardous or harmful way. Persistent drinking at these levels can result in damage to almost every organ or system of the body. NICE has published a guideline on Diagnosis and clinical management of alcohol-related physical complications. A number of key priorities for implementation are listed in the guideline:

Hospital admission should be offered to people who are in acute alcohol withdrawal or who are at high risk of this condition
Healthcare professionals who care for people who are in acute alcohol withdrawal should be skilled in the assessment and monitoring of withdrawal symptoms and signs
Patients who still have decompensated liver disease after best management and have abstained from alcohol for 3 months should be referred for assessment for liver transplantation
Patients with pain from chronic alcohol-related pancreatitis should be referred to a specialist centre for multidisciplinary assessment.

A guideline on preventing the development of hazardous and harmful drinking has also been published by NICE, which aims to aid early identification of alcohol-use disorders.

www.nice.org.uk

Recommendations in NICE skin cancer guideline updated

NICE has updated the section on the diagnosis and removal of ‘low-risk’ basal cell carcinomas (BCCs) in primary care in its guideline, Improving outcomes in cancer for people with skin tumours including melanoma.

The updated guideline now makes it clear that primary care trusts and local health boards should ensure all healthcare professionals who diagnose, manage, and excise low-risk BCCs are fully accredited to do so, and undergo continuous professional development in the diagnosis and management of skin lesions to maintain their accreditation. The remaining recommendations in the guideline remain unchanged.

www.nice.org.uk

SIGN has updated its guideline on stroke rehabilitation

It aims to help individual clinicians, primary care teams, hospital departments, and hospitals to optimise their management of patients with stroke with an emphasis on the first 12 months after stroke.

www.sign.ac.uk

A guideline on constipation in children and young people has been published by NICE

It provides strategies based on the best available evidence to support early identification, positive diagnosis, and timely, effective management.

www.nice.org.uk

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