Information for sites when discussing UPSTREAM with a patient

Please find below some points which may be helpful when discussing UPSTREAM with a man considering whether to participate;

• Men who continue to be bothered by urinary symptoms despite initial treatment are often keen to look for further treatment 

• There is a wide range of treatments for urinary symptoms, and sometimes surgery is the most effective option 

• Deciding which further treatment is most appropriate often needs some additional tests.  In the NHS, these include questionnaires, bladder diaries, flow rate tests and urodynamics (as described in the UPSTREAM patient information leaflets) 

• At the moment we don’t know whether tests including urodynamics are better than tests without urodynamics. So, UPSTREAM is a research project which is working out what the results of treatment are for men who underwent tests with or without urodynamics 

• If you take part in the study, you will have a set of tests which will either include or not include urodynamic tests. Whether you have urodynamics will be chosen at random, as this is the most scientific way to make sure the role of urodynamics can be properly understood 

• Whichever group you fall into, the tests you have will be a standard set of tests used in NHS hospitals (since some hospitals routinely use urodynamic tests and others do not) 

• Once the tests are completed, the urologist will review the results and will recommend what treatments you might consider 

• You will be able to choose which treatment you actually receive; in other words, your treatment will not be chosen at random, and you do not have to accept the urologist’s recommendation 

• Participating in the UPSTREAM trial is optional; if you decide not to take part, or withdraw from the study later on, you will still receive the treatment needed for your urinary symptoms