Yap Tet L, Brown Christian, Cromwell David A, van der Meulen Jan, Emberton Mark
Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK.
BJU Int. 2009 Oct;104(8):1104-8. doi: 10.1111/j.1464-410X.2009.08497.x. Epub 2009 May 25.
To assess the effect of a self-management programme (SMP) on actual voiding behaviour using frequency-volume chart (FVC) data.
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.
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.
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.
使用频率-容量图表（FVC）数据评估自我管理计划（SMP）对实际排尿行为的影响。
总共招募了140名患有单纯性下尿路症状（LUTS）的男性，并将他们随机分为两组，一组除接受标准护理外还参加SMP，另一组仅接受标准护理。SMP组参加了三次小组会议，会议涉及行为问题并提供了解决问题策略的培训。在基线时以及3、6和12个月时，患者在泌尿外科诊所接受评估，评估后完成国际前列腺症状评分（IPSS）和为期3天的FVC。通过意向性分析计算并分析SMP组和对照组之间排尿行为的差异。
140名患者中，104名在基线时完成了FVC数据；在3、6和12个月时，分别收到了99份、95份和70份图表。随机分组的两组之间基线FVC变量相当。在3个月时，SMP组的平均排尿量增加，与对照组相比，平均（95%置信区间，CI）增加了57（33 - 83）mL。SMP组的排尿总数和夜尿次数也较低，平均（95%CI）分别减少了2.6（-3.6至-1.5）次和0.7（-1.1至-0.3）次。这些变化在6个月和12个月时得以维持。
根据FVC监测，除标准护理外，SMP显著改善了尿频和夜尿等泌尿症状。其确切作用机制以及影响此效果的具体干预措施需要进一步研究。
