Benign prostatic hyperplasia evaluation, treatment and association with sexual dysfunction: practice patterns...

Area of Science:

• Urology
• Men's Health
• Primary Care Medicine

Background:

• Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) are common in aging men.
• Sexual dysfunction (SD) affects 40-70% of men with LUTS/BPH.

Purpose of the Study:

• To assess US urologists' (UROs) and primary care physicians' (PCPs) knowledge of the 2003 American Urological Association (AUA) guideline on BPH management.
• To evaluate practice patterns in LUTS/BPH diagnosis, treatment, and association with SD.

Main Methods:

• A 19-question qualitative survey was mailed to 7500 UROs and 17,500 PCPs in April 2004.
• Responses were collected until May 2004, with 788 surveys returned (437 UROs; 351 PCPs).

Main Results:

• PCP awareness and use of the AUA-Symptom Index/International Prostate Symptom Score (AUA-SI/IPSS) for LUTS assessment were significantly lower than UROs (62% vs. 97% awareness; 41% vs. 81% use).
• Alpha-blocker monotherapy was the preferred treatment for both groups.
• PCPs reported higher rates of SD in association with LUTS/BPH and BPH pharmacotherapy compared to UROs.
• Tamsulosin and doxazosin showed higher rates of ejaculatory dysfunction (EjD) and erectile dysfunction (ED) side effects than alfuzosin.

Conclusions:

• Many PCPs are not utilizing the AUA-SI/IPSS for LUTS assessment in aging male patients.
• Both UROs and PCPs appear to underestimate the prevalence of SD in men with LUTS/BPH compared to epidemiological data.