title: Application of guidelines to the evaluation of the male patient with urgency and/or incontinence.
abstract: OBJECTIVE
  To review and evaluate the evidence from contemporary evidence-based guidelines regarding the assessment of men with urinary urgency and/or incontinence.
  
  
  RESULTS
  There are a number of evidence-based guidelines which describe the pathways for assessing men with the symptoms of urgency and/or incontinence. We summarize the conclusions of the European Association of Urology, American Urological Association and National Institute of Clinical Excellence guidelines.
  
  
  CONCLUSIONS
  All guidelines recommend a directed history, examination (including digital rectal examination), urinalysis and bladder diary as being essential in the assessment of men with lower urinary tract symptoms, although there are no high levels of evidence studies to support this. Creatinine estimation and prostate-specific antigen are recommended in selected groups of men, the latter after appropriate counselling. Uroflowmetry with postvoid residual assessment is recommended for at specialist assessment. Pad tests may be useful to quantify leakage. Ultrasound assessment of prostatic size and protrusion into the bladder base may be useful. Cystometry is recommended for men considering prostatic surgery, although there is a poor level of evidence underpinning this. Noninvasive surrogates for cystometry, such as penile plethysmography, lack sufficient evidence to allow recommendations to be made.
authors.affiliation: Sheffield Teaching Hospitals, Sheffield, UK.
authors.forename: Altaf
authors.initials: A
authors.lastname: Mangera
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Chapple
mesh_terms: D003404:Creatinine / Q000097:blood; D019317:Evidence-Based Medicine; D006801:Humans; D007610:Kallikreins / Q000097:blood; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis / Q000209:etiology; D008297:Male; D017410:Practice Guidelines as Topic; D011467:Prostate / Q000000981:diagnostic imaging*; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000150:complications / Q000175:diagnosis*; D014463:Ultrasonography; D016482:Urinalysis; D053201:Urinary Bladder, Overactive / Q000150:complications / Q000175:diagnosis*; D053202:Urinary Incontinence, Urge / Q000175:diagnosis* / Q000209:etiology; D014563:Urodynamics
chemical_list: D003404:Creatinine; C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen