The Diagnosis and Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia by Primary Care Family Physicians in Portugal

Fonseca, Júlio; Martins-Silva, Carlos

doi:10.1007/s40261-014-0256-4

Cited by 4 publications

(5 citation statements)

References 17 publications

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“…Twenty-one (21) studies were affiliated to healthcare provider, 15,[17][18][19][22][23][24][25][26]28,31,34,35,[37][38][39]41,42,44,46,48 fourteen to academic institutions, 21,27,29,30,32,33,36,40,43,45,47,[49][50][51] one related to regulatory institution 16 and other to the pharmaceutical industry. 20 Heterogeneity could not be explained by this subgroup analysis (I 2 =99% for academic institution affiliation and I 2 =98% for healthcare provider affiliation).…”

Section: Resultsmentioning

confidence: 77%

“…Four different delivery modes were used in the included studies: e-mail, [17][18][19][20][21][22] postal, 16,[23][24][25][26][27][28][29][30][31][32][33][34][35][36] personal contact (i.e., researchers delivered the questionnaire directly to the potential respondent) 15,37-50 and telephone-based surveys. 51 Subgroup analysis suggests that response rates differed in studies which used different survey delivery modes (interaction test p<0.0001).…”

Section: Resultsmentioning

confidence: 99%

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Portuguese Primary Care physicians response rate in surveys: A systematic review

Basílio

Cardoso²,

Laranjo

et al. 2018

Rev. Assoc. Med. Bras.

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Section: Resultsmentioning

confidence: 77%

Section: Resultsmentioning

confidence: 99%

Portuguese Primary Care physicians response rate in surveys: A systematic review

Basílio

Cardoso²,

Laranjo

et al. 2018

Rev. Assoc. Med. Bras.

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“…A greater involvement of the primary care sector in the management of LUTS is believed to allow a more rational use of resources as a result of reduced time spent on waiting lists, earlier therapy, and increased access to specialist services for those in need of extensive investigations or surgery. 11 In this sense, it is understandable that it is those mostly highly symptomatic patients who have failed medical therapy are referred to urologists. Intriguingly, fewer respondents in Hong Kong than in other South-East Asian countries reported being given prescribed treatment, suggesting that primary care physicians adopt a more conservative approach to the treatment of LUTS, although this remains to be confirmed with findings from medical records.…”

Section: Respondent's Perception Of Bother and Satisfaction With Prevmentioning

confidence: 99%

Patient opinion of lower urinary tract symptoms and their treatment: a cross-sectional survey in Hong Kong public urology clinics

Chan

Chu

2017

Hong Kong Med J

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Introduction: Lower urinary tract symptoms collectively represent a common condition among ageing men. There are, however, limited data on the frequency of individual symptoms in patients who seek specialist care. We conducted a multinational survey in South-East Asia to evaluate patients' self-reported prevalence, bother, treatment, and treatment satisfaction of four lower urinary tract symptoms namely, urgency, nocturia, slow stream, and post-micturition dribble. This report presents the analysis of the Hong Kong subpopulation. Methods:This cross-sectional survey involved adult men aged over 18 years who attended a urology out-patient clinic because of lower urinary tract symptoms. A structured questionnaire, translated and validated in the local languages, was selfadministered by patients. Results:Of 1436 respondents surveyed in the region, 225 were from Hong Kong of whom most were aged 56 to 75 years, retired, and had no history of any previous prostate surgery. Overall, the self-reported prevalence of nocturia of at least one void per night was 93% (95% confidence interval, 90%-97%), slow stream 76% (71%-82%), post-micturition dribble 70% (64%-76%), and urgency 50% (43%-56%). Symptoms for which most respondents reported "some" or "a lot" of bother included: nocturia, defined as at Patient opinion of lower urinary tract symptoms and their treatment: a cross-sectional survey in

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“…The first article is dedicated to primary-care physicians' patterns of practice assessment of men with LUTS/ BPH in Portugal [21]. This article adds valuable information regarding the characteristics of men who seek medical help for LUTS, to the diagnostic approach, and on factors that trigger referrals to urologists.…”

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confidence: 99%

Latest Developments in the Assessment and Treatment of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: What is Clinically Relevant?

Oelke

2015

Clin Drug Investig

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Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) are prevalent and increase with aging. Epidemiological studies have shown that approximately 40 % of men aged C50 years have bothersome LUTS/BPH [1]. It is therefore not surprising that LUTS/BPH are positioned at 7th place in the most frequently diagnosed and most costly diseases in men aged C50 years [2]. Healthcare-seeking behavior is triggered by LUTS severity and LUTS phenotypes. Men often consult their doctors when they have severe LUTS or experience urinary urgency or nocturia [1,3]. LUTS/BPH have a multifactorial etiology and can be caused by the prostate, bladder, urethra, pelvic floor, central or peripheral nervous system, ureters, or even by the kidneys in case of nocturnal polyuria [4]. LUTS can be divided into storage (e.g., urgency, frequency, nocturia), voiding (e.g., hesitancy, poor stream, intermittency), and post-micturition symptoms (post-void dribbling, feeling of incomplete bladder emptying) [5].The majority of guidelines on LUTS/BPH have been established by urologists [4,6,7] but can also be-more or less easily-implemented by other medical specialties. Different healthcare systems worldwide have different regulations and defined responsibilities regarding which medical specialty should primarily assess and treat men with LUTS/BPH. While almost three-quarters of men with LUTS/BPH in Germany are diagnosed and treated by urologists [8], the majority of men in other countries, for example Australia or the UK, are managed by primary-care physicians. Specialized training programs and experience with patients with LUTS/BPH are therefore mandatory for different medical specialties.Careful assessment helps to identify the underlying pathophysiology of LUTS. Simple patient history or a symptom questionnaire cannot distinguish between LUTS of benign or malignant origin because the type of symptom or symptom severity is nonspecific for the underlying disease. This may limit the widespread assessment and treatment of LUTS by non-urologic professionals because special assessment tools-before treatment initiation-are usually not available in the offices of primary-care physicians (e.g., uroflowmeter, transrectal ultrasound, multichannel urodynamics, urethrocystoscopy). It is therefore crucial to know when nonurologists should transfer their patients to specialized urology care. An expert panel recommended specialized urology support in particular when physicians are in doubt of the origin or benign character of LUTS, in cases of macroscopic hematuria, or in men with absolute indications for prostate surgery [9].Adherence to guidelines is crucial for every medical specialty dealing with LUTS/BPH because real-life practice in the USA has shown that doctors who follow guidelines perform significantly less prostate surgery than doctors who do not [10]. Doctors with poor adherence to guidelines will have performed prostate surgery within the first year of diagnosis in 11 % of patients, whereas doctors with good adherence to guide...

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The Diagnosis and Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia by Primary Care Family Physicians in Portugal

Abstract: Primary care physicians in Portugal usually diagnose and treat patients with LUTS/BPH rather than refer them to a urologist. Physicians' age and experience, and patients' age, comorbidities and symptom severity affect the management of LUTS/BPH in primary care in Portugal.

Cited by 4 publications

References 17 publications

Portuguese Primary Care physicians response rate in surveys: A systematic review

Portuguese Primary Care physicians response rate in surveys: A systematic review

Patient opinion of lower urinary tract symptoms and their treatment: a cross-sectional survey in Hong Kong public urology clinics

Latest Developments in the Assessment and Treatment of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: What is Clinically Relevant?

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