Korean Urologist’s View of Practice Patterns in Diagnosis and Management of Benign Prostatic Hyperplasia: A Nationwide Survey
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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.
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.
참고문헌 (14)
- Pomer S, "The therapy of benign prostatic hyperplasia using less-invasive procedures: the current situation", BJU Int, 89, pp.773~775 (2002)
- Petros Sountoulides, "The Evolution of KTP Laser Vaporization of the Prostate", Yonsei Medical Journal, 49(2), pp.189~199 (2008), 연세대학교의과대학
- AUA Practice Guidelines Committees, "AUA guideline on management of benign prostatic hyperplasia (2003). Chapter 1: Diagnosis and treatment recommendations", J Urol, 170, pp.530~547 (2003)
- Irani J, "International comparison of guidelines for the management of benign prostatic hyperplasia: use of a validated generic tool", Prog Urol, 14, pp.29~32 (2004)
- Irani J, "A review of guidelines on benign prostatic hyperplasia and lower urinary tract symptoms: are all guidelines the same?", BJU Int, 92, pp.937~942 (2003)
- Madersbacher S, "EAU 2004 guidelines on assessment, therapy and follow-up of men with lower urinary tract symptoms suggestive of benign prostatic obstruction (BPH guidelines)", Eur Urol, 46, pp.547~554 (2004)
- Nickel JC, "Canadian guidelines for the management of benign prostatic hyperplasia", Can J Urol, 12, pp.2677~2683 (2005)
- Oelke M, "German guidelines for the assessment of BPH. What’s new in 2007?", Urologe A, 47, pp.149~154 (2008)
- Spatafora S, "Evidencebased guidelines for the management of lower urinary tract symptoms related to uncomplicated benign prostatic hyperplasia in Italy: updated summary", Curr Med Res Opin, 23, pp.1715~1732 (2007)
- Chung BH, "Relationship between serum prostate-specific antigen and prostate volume in Korean men with benign prostatic hyperplasia: a multicentre study", BJU Int, 97, pp.742~746 (2006)
- Lee E, "Prevalence of lower urinary tract symptoms in Korean men in a community-based study", Eur Urol, 33, pp.17~21 (1998)
- Barry MJ, "A nationwide survey of practicing urologists: current management of benign prostatic hyperplasia and clinically localized prostate cancer", J Urol, 158, pp.488~491 (1997)
- Ramsey EW, "Practice patterns of Canadian urologists in benign prostatic hyperplasia and prostate cancer. Canadian Prostate Health Council", J Urol, 163, pp.499~502 (2000)
- Emberton M, "Understanding patient and physician perceptions of benign prostatic hyperplasia in Europe: The Prostate Research on Behaviour and Education (PROBE) Survey", Int J Clin Pract, 62, pp.18~26 (2008)