DisclosuresA. D. Seftel: consultant to Lilly, Pfizer, Auxilium, Indevus, sanofi-aventis and Solvay. R. C. Rosen: consultant to sanofi-aventis. M.T. Rosenberg: consultant to Astellas, GSK, Novartis, sanofi-aventis, Ortho-McNeil, Pfizer and Verathon; speaker for Astella, GSK, Ortho-McNeil and Verathon; research funding from sanofi-aventis and Ortho-McNeil. R. Sadovsky: none. [Correction added after the online publication, 21st February 2008, where the following statement was omitted from the Disclosure section] As Urology Section Editor for the Journal, Matt T. Rosenberg withdrew from the review process and deferred all editorial decisions to Graham Jackson.
Benign prostatic hyperplasia evaluation, treatment and association with sexual dysfunction: practice patterns according to physician specialty
Article first published online: 8 FEB 2008
© 2008 The Authors
International Journal of Clinical Practice
Volume 62, Issue 4, pages 614–622, April 2008
How to Cite
Seftel, A. D., Rosen, R. C., Rosenberg, M. T. and Sadovsky, R. (2008), Benign prostatic hyperplasia evaluation, treatment and association with sexual dysfunction: practice patterns according to physician specialty. International Journal of Clinical Practice, 62: 614–622. doi: 10.1111/j.1742-1241.2008.01699.x
- Issue published online: 6 MAR 2008
- Article first published online: 8 FEB 2008
- Paper received September 2007, accepted January 2008
Aims: Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) are a common problem in ageing men and are accompanied by sexual dysfunction (SD) in 40–70% of men evaluated in large-scale epidemiological studies. One year after the 2003 American Urological Association (AUA) guideline on BPH management was published, a survey of US urologists (UROs) and primary care physicians (PCPs) was conducted to ascertain physician knowledge of the AUA guideline and practice patterns regarding LUTS/BPH diagnosis, treatment and association with SD.
Methods: A 19-question qualitative survey, sponsored by the American Foundation of Urologic Disease, was mailed April 2004 to 7500 UROs and 17,500 PCPs, with responses collected until May 2004.
Results: A total of 788 surveys were returned (437 UROs; 351 PCPs). Only 62% of PCPs were aware of and only 41% of PCPs used the AUA-Symptom Index/International Prostate Symptom Score (AUA-SI/IPSS) to assess LUTS compared with 97% and 81% of UROs respectively. Alpha-blocker monotherapy was the treatment of choice for both UROs and PCPs. Compared with UROs, PCPs reported higher rates of SD in association with LUTS or BPH (37% vs. 27%) and BPH pharmacotherapy (27% vs. 21%). UROs and PCPs reported higher rates of SD side effects [ejaculatory dysfunction (EjD) and erectile dysfunction (ED)] for tamsulosin (EjD: UROs 22%, PCPs 12%; ED: UROs 7%, PCPs 10%) and doxazosin (EjD: UROs 14%, PCPs 10%; ED: UROs 7%, PCPs 12%) than for alfuzosin (EjD: UROs 6%, PCPs 4%; ED: UROs 4%, PCPs 5%).
Conclusions: The results suggest that many PCPs are not using the AUA-SI/IPSS to assess LUTS in their ageing male patients. Both UROs and PCPs appear to be underestimating the prevalence of SD in men with LUTS/BPH relative to prevalence rates reported in large-scale epidemiological studies.