Purpose To identify the expectations of men with LUTS referred to a urologist and to study the association between those expectations and satisfaction with the care provided. Methods In this prospective cohort study, adult men with LUTS completed a questionnaire before their first outpatient appointment, and again at 6 and 12 weeks. The questionnaires included IPSS and OABq-SF, and self-constructed questions on patient expectations, outcome of expectations and satisfaction. Results Data from 182 participants showed positive expectations about the urologist performing examinations, providing explanations and finding the underlying cause, but mostly neutral expectations for treatment plans and outcomes. Positive treatment expectations were associated with positive expectations about outcomes after physiotherapy, drug treatment and surgery. Higher symptom scores and age were associated with higher expectations about drug treatment. Expectations were subjectively and objectively fulfilled for 66.4% and 27.3%, respectively. Symptom improvement (decrease in IPSS scores) was significantly more in men with objectively fulfilled expectations than in men with no unfulfilled expectations. No significant difference was present between men with subjectively fulfilled expectations and men with unfulfilled expectations. However, satisfaction was significantly higher for patients with subjectively fulfilled expectations at 6 and 12 weeks compared with those who had unfulfilled expectations. Conclusion Most men referred to a urologist with LUTS do express clear expectations about treatment in secondary care. Patients with higher expectations for treatment outcomes are more likely to expect to receive that treatment. Satisfaction with the care of a urologist is also higher when patients self-report that they receive the treatment they expected.

Huub van der Vaart gynaecoloog, Universitair Medisch Centrum Utrecht en medisch directeur, Alantvrouw Henk-JanMulder nurse practitioner urologie, Martiniziekenhuis, Groningen Het Landelijk Expertisecentrum Verpleging & Verzorging (LEVV) ontwikkelt momenteel twee richtlijnen voor urine-incontinentie, één voor vrouwen en één voor kwetsbare ouderen. De richtlijnen geven antwoord op diverse knelpunten die door een Deskundigencommissie incontinentie (DINC) zijn geïnventariseerd. Dit artikel richt zich op het ontwikkelen van de richtlijn 'Urine-incontinentie bij vrouwen', waarbij een adaptatieproces wordt doorlopen. Een richtlijn van de National Institute for Health and Clinical Excellence (NICE) was de basis voor het adaptatieproces. R I C H T L I J N E N het adapteren van een richtlijn Bestelkaart ■ Ja, ik neem graag een abonnement op NTvEBP (verschijnt vijfmaal per jaar) ■ Particulier € 73,-(alleen tijdschrift) ■ Particulier € 85,-(tijdschrift en online toegang) ■ Instellingen € 141,75 (alleen tijdschrift*) * Voor online voor instellingen gelden andere tarieven, hiervoor kunt u contact opnemen met onze klantenservice (030) 638 37 36. U kunt de bestelkaart retourneren aan: Bohn Stafl eu van Loghum, t.a.v. Mevr. J. Meulesteen Antwoordnummer 2767, 3970 WJ Houten Onze leveringsvoorwaarden zijn in te zien op www.bsl.nl. Tenzij anders vermeld, zijn alle prijzen inclusief BTW, en exclusief verzend-en administratiekosten. Prijswijzigingen voorbehouden. Uw gegevens kunnen door Bohn Stafl eu van Loghum worden gebruikt om u te informeren over relevante producten en diensten. Indien u hier bezwaar tegen heeft, kunt u contact met ons opnemen. Kies voor verdieping Lees EBP! www.ebp.bsl.nl nederlands tijdschrift voor evidence based practice EBP T O E P A S S I N G I N D E P R A K T I J K

AimsTo explore the effect of an online self‐management program in secondary care for men with lower urinary tract symptoms (LUTS).MethodsWe performed a prospective nonrandomized double‐cohort pilot study of consecutive adult men referred with uncomplicated LUTS to three urology outpatient departments. Men in both cohorts received care as usual from a urologist, but men in the intervention cohort also had access to an online self‐management program. Outcomes were assessed after 6 and 12 weeks: LUTS severity was assessed with the International Prostate Symptom Score (IPSS), the Overactive Bladder Questionnaire (OABq), and the Perceived Global Impression of Improvement (PGI‐I). The main outcome of interest was a clear improvement in the PGI‐I scores (“much better” or “very much better”).ResultsAge, symptom severity, and quality of life scores were comparable between the intervention (n = 113) and standard care (n = 54) cohorts. Clear improvement in the PGI‐I scores was reported after 12 weeks in 19.4% and 26.1% of men in the intervention and standard care cohorts, respectively. However, logistic regression analysis indicated that the difference between cohorts was not significant. Multivariable linear regression analysis also indicated no significant differences between cohorts for the IPSS or the OABq score at either assessment point. Notably, the uptake of the intervention was low (53%).ConclusionsWe found no significant benefit from adding an online self‐management program to standard care for men with LUTS, probably due to the low uptake of the intervention that may have resulted from the timing in the care pathway.