GENERAL PRACTITIONERS’ APPROACH TO PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA
Abstract
Background. Due to growing prevalence of benign prostatic hyperplasia (BPH) author of this article wanted to establish how general practitioners (GPs) treat patients with this disease. I was interested in differences in discovering, treating and referring to urologists among physicians considering their active years, education (specialist/non-specialist) and type of practice (private practice/physician in a health care centre – non-private) physicians. The assumption was that procedures of GPs deviate from recommended professional guidelines.
Methods. As a pattern of the survey 140 physicians in general practice, who work in the areas of the two biggest Slovenian cities of Ljubljana and Maribor and their environs, were chosen. An anonymous questionnaire with ten questions was sent to them.
Results. In the final analysis data from 76 (54%) correctly completed polls were included. Physicians have estimated that in the population of their patients 6.1 ± 4.9% (median 5%) have BPH. 47.4% of physicians treat the newly diagnosed patients with symptoms of this disease themselves while 42.1% of physicians immediately refer such patients to urologists. As far as the recommended diagnostic procedures for estimating BPH symptoms are concerned, 51.3% of physicians use a questionnaire, 47.4% of physicians use digital rectal examination and 40.8% determine the serum creatinine level. Among the optional diagnostic procedures PSA is determined by 63.2% of physicians and 50% order postvoid residual urine by ultrasound. Statistics show that non-private physicians decide to determine serum creatinine level (p < 0.01) and PSA (p < 0.01) significantly more often than private physicians. 68.5% of physicians are familiar with the international questionnaire AUA symptom index/IPSS used as diagnostic tool. The most frequent therapeutic measures taken by GPs with a BPH patient are: prescription of alpha-blockers (75%), prescription of finasteride (71%) and expectant therapy with regular controls (70%).
Conclusions. According to the recommendations, the results of the study confirm a considerable deviation from the diagnostic procedures taken by GPs with BPH patients. Optimal mutual care of BPH patients by urologists and GPs would require improvement of professional knowledge of the latter.
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