Patient's and physician's behavior on the management of benign prostatic hyperplasia among the patients at the risk of clinical progression. A multicenter noninterventional trial in Slovakia by "Prostate and Expectations of Treatment: Epidemiology Research" (PETER) study group.

ABSTRACT

OBJECTIVES: The aim of the survey was to assess physician's behavior and the global knowledge about patient's preferences and their psychological burden linked to lower urinary tract symptoms (LUTS) in an outpatient setting in Slovakia. METHODS: The study included 36 outpatient urological clinics. Overall, 1132 newly diagnosed LUTS patients were screened within 1 month. A total of 454 questionnaires were obtained from 459 LUTS patients with risk of progression (RP). Inclusion criteria were age > 50 years, IPSS > 8, prostate volume ≥ 30 cm3, and PSA ≥ 1.5 to ≤ 10 ng/ml. RESULTS: The digital rectal examination, PSA testing, and urinalysis were used in all the centers as first visit examinations. The least frequently performed diagnostic procedure was uroflowmetry (74 %). The physician's preferred therapy for patients with RP was standard combined treatment in (52.6 %); followed by α-blocker alone (45 %) and monotherapy with 5-α-reductase inhibitors (5-ARI) only in 3 % of all asked urologists. Patient's mean age was 63.3 years (SD ± 7.4); baseline PSA value 2.2 ng/ml (SD + 3.2); prostate volume was 38.0 ml (SD ± 16.7 ml); Qmax was 11.5 ml/s (SD ± 4.6); and IPSS score 12.5 (SD ± 6.3). The most bothersome symptoms were nocturia (prevalence of ≥ 75 %), weak urinary stream (61 %), and retarded voiding (43 %). Patient's expectations of treatment were rapid improvement of symptoms (36.0 %), stabilization of symptoms (35.5 %), and reduction of potential risk of surgical intervention (25.8 %). CONCLUSIONS: Our research reflects the physician's behavior, patient's self-perception of the disease and therapeutic priorities in the current outpatient practice in Slovakia.