Published by HealthCanal.com
For the first time ever, a major new clinical trial, led by the Bristol Urological Institute at Southmead Hospital Bristol, aims to assess the clinical and cost effectiveness of urological tests in men who have difficulty passing urine. The trial is being managed by the Bristol Randomised Trials Collaboration at the University of Bristol’s School of Social and Community Medicine.
As they get older, some men develop problems and difficulties passing urine. This may be for a number of reasons including an enlarged prostate gland – which narrows the bladder outlet (urethra), or because the bladder becomes less able to contract.
Prostate surgery is more likely to help symptoms in the first group of patients, while the second group may have no improvement after surgery and this could be wrong for them due to risk of complications including incontinence. Urodynamics involves putting a small tube (catheter) into the bladder via the penis, and another into the rectum, to measure bladder and abdominal pressures while the bladder is filled with a sterile fluid. The procedure is considered safe, but some men find it uncomfortable or undignified, and a few develop urine infection afterwards.
Urodynamics can measure some aspects of bladder function, such as bladder pressures during filling and voiding, and bladder outlet obstruction pressures.
Consultant Urologist Marcus Drake, who will lead the trial, said: “We think that it could be useful to select the men who should and should not have surgery. However, no studies have been conducted so far to tell us if this is true. This study is designed to find out if the invasive tests are worthwhile.
“UPSTREAM is a randomised controlled trial in men who have bothersome difficulty passing urine and who are considering having surgery for their symptoms.”
