Managing lower urinary tract symptoms in primary care: qualitative study of GPs' and patients' experiences

Br J Gen Pract. 2021 Aug 26;71(710):e685-e692. doi: 10.3399/BJGP.2020.1043. Print 2021 Sep.

Abstract

Background: Lower urinary tract symptoms (LUTS) are common in males aged ≥40 years and have a considerable impact on quality of life. Management can be complex, and although most LUTS could be treated effectively in primary care, referrals to urology outpatients are increasing.

Aim: To explore GPs' experiences of managing LUTS together with patients' experiences of and preferences for treatment in primary care.

Design and setting: Telephone interviews were conducted with GPs and male patients presenting to primary care with bothersome LUTS.

Method: Eleven GPs and 25 male patients were purposively sampled from 20 GP practices in three UK regions: Newcastle upon Tyne, Bristol, and South Wales. Interviews were conducted between May 2018 and January 2019, and were analysed using a framework approach.

Results: Difficulty establishing causes and differentiating between prostate and bladder symptoms were key challenges to the diagnosis of LUTS in primary care, often making treatment a process of trial and error. Pharmacological treatments were commonly ineffective and often caused side effects. Despite this, patients were generally satisfied with GP consultations and expressed a preference for treatment in primary care.

Conclusion: Managing LUTS in primary care is a more accessible option for patients. Given the challenges of LUTS diagnosis, an effective diagnostic tool for use by GPs would be beneficial. Ensuring bothersome LUTS are not dismissed as a normal part of ageing is essential in improving patients' quality of life. Greater exploration of the role of non-pharmacological treatments is needed.

Keywords: general practice; lower urinary tract symptoms; primary health care; qualitative research; urology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel
  • General Practitioners*
  • Humans
  • Lower Urinary Tract Symptoms* / diagnosis
  • Lower Urinary Tract Symptoms* / therapy
  • Male
  • Primary Health Care
  • Qualitative Research
  • Quality of Life
  • Referral and Consultation