Yonsei Med J.  2010 Mar;51(2):248-252. 10.3349/ymj.2010.51.2.248.

Korean Urologist's View of Practice Patterns in Diagnosis and Management of Benign Prostatic Hyperplasia: A Nationwide Survey

• Oh CY
• Lee SH
• Yoo SJ
• Chung BH

• KMID: 1126026
• DOI: http://doi.org/10.3349/ymj.2010.51.2.248

Abstract

PURPOSE
In Korea, there was no specific guidelines for the management of benign prostatic hyperplasia (BPH). We reviewed the practice patterns of Korean urologists in the management of BPH and aimed to describe the need to develop specific guidelines.
MATERIALS AND METHODS
A probability sample was taken from the Korean Urological Association Registry of Physicians, and a structured questionnaire, that explored practice patterns in the management of BPH, was mailed to a random sample of 251 Korean urologists.
RESULTS
For the initial evaluation of BPH, most urologists routinely performed prostatic specific antigen (PSA) (96.4%), digital rectal exam (94.4%), international prostate symptom score (IPSS) (83.2%) and transrectal ultrasound (79.2%). Symptom assessment (36.4%) followed by transrectal ultrasound of prostate (TRUS) (20.0%) was considered as the most important diagnostic examination affecting the decision about individual treatment options. Almost all urologists (92.2%) chose medical treatment as the first-line treatment option for uncomplicated BPH with moderate symptoms. Of the respondents, 57.2% had prescribed alpha blocker and 41.6% alpha blocker plus 5-alpha reductase inhibitors as the medical treatment option for BPH. The prescription of 5-ARIs was dependent on the size of the prostate and the severity of symptoms.
CONCLUSION
The results of our current survey provide useful insight into variations in the clinical practice of Korean urologists. They also indicate the need to develop further practical guidelines based on solid clinical data and to ensure that these guidelines are widely promoted and accepted by the urological community.

Keyword

Drug therapy; physician's practice patterns; prostate; prostatic hyperplasia; prostatic neoplasm

MeSH Terms

Adrenergic alpha-Antagonists/therapeutic use
Cholestenone 5 alpha-Reductase/antagonists & inhibitors
Data Collection
Humans
Korea
Male
Prostatic Hyperplasia/*diagnosis/*drug therapy
Urology/statistics & numerical data

Figure

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  Fig. 1 Common symptoms that are frequently complained by patients with benign prostatic hyperplasia.

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  Fig. 2 The choice of non pharmacological therapy during the preceding 12 months (multiple choice). TURP, transurethral resection of the prostate; TUNA, transurethral needle ablation; TUDP, transurethral balloon dilation of the prostate.

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  Fig. 3 The initial choices of pharmacological therapy for the newly diagnosed BPH patients. CAM, complimentary alternative medicine; BPH, benign prostatic hyperplasia.

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  Fig. 4 Main concerns of the urologists that affect the initial treatment of the patients with BPH. BPH, benign prostatic hyperplasias; AUR, acute urinary retention.

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