Understanding patient and physician perceptions of benign prostatic hyperplasia in Asia Pacific, Latin America and the Commonwealth of Independent States: the Prostate Research on Behaviour and Education ( PROBE ) II survey

Abstract

SummaryAimTo assess attitudes and beliefs towards benign prostatic hyperplasia (BPH)/ lower urinary tract symptoms (LUTS) and its treatment among patients and physicians in Latin America, Asia Pacific and the Commonwealth of Independent States (CIS).MethodsCross‐sectional, quantitative study conducted between December 2014 and September 2015. Separate questionnaires were administered to BPH/LUTS patients receiving drug treatment for their condition and to practising physicians who treat patients with BPH/LUTS.ResultsIn total, 1094 patients and 202 physicians completed a questionnaire. Most patients (61%) felt very/fairly well informed about BPH/LUTS, and 60% of physicians perceived patients to be very/somewhat informed. Overall, 70% of physicians felt that it would be valuable to raise awareness of BPH/LUTS and encourage men to consult a physician. The first symptoms most commonly noticed by patients were need to urinate more frequently, slower/weaker stream and nocturia. At first consultation, 71% of patients recalled providing a urine sample, 57% having a blood test for prostate‐specific antigen and 56% a digital rectal examination being performed. Over two thirds of patients (69%) were satisfied with their current medication; highest satisfaction rates (among both patients and physicians) were reported for alpha blockers and 5ARIs, either as monotherapies or used in combination. Patients were prepared to wait longer for symptom relief in order to have a reduced risk of surgery. Most physicians (90%) thought that at least some patients believe BPH/LUTS to be a progressive condition. Most physicians thought that patients were very/fairly concerned about BPH surgery (92%) and acute urinary retention (72%); 52% of physicians thought treatment adherence was “extremely” important.ConclusionsThis study provides valuable insights into the attitudes and beliefs of patients and physicians in Asia Pacific, Latin America and CIS about BPH/LUTS and its management. It also highlights areas of discordance between patient/physician perceptions and beliefs about BPH/LUTS, and potential areas of focus to improve the experience of affected patients.

Comparison of the clinical effect of dutasteride therapy for benign prostatic hyperplasia when initiated at different time points: A multicentre, observational, retrospective chart review study

“…Benign prostatic hyperplasia (BPH), characterised by lower urinary tract symptoms (LUTS), is highly prevalent among ageing men, with more than one‐third of those aged 50 years or over experiencing moderate‐to‐severe LUTS . The symptoms of BPH are known to substantially impair the quality of life for patients . Importantly, patients who visit their clinician because of LUTS may already have moderate‐to‐severe symptoms and, as such, are at an increased risk of further disease progression …”

“…The symptoms of BPH are known to substantially impair the quality of life for patients . Importantly, patients who visit their clinician because of LUTS may already have moderate‐to‐severe symptoms and, as such, are at an increased risk of further disease progression …”

“…moderate-to-severe symptoms 4 and, as such, are at an increased risk of further disease progression. [5][6][7] In patients with BPH and moderate-to-severe LUTS who are at an increased risk of disease progression, the recommended first-line treatment is combination therapy with a 5-alpha reductase inhibitor (5ARI) and alpha-1 blockers (a1Bs).…”

A prospective randomised placebo‐controlled study of the impact of dutasteride/tamsulosin combination therapy on sexual function domains in sexually active men with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH)

“…Although supported by guideline recommendations , patient preference , and clinical studies findings indicating efficacy , clinicians are reluctant to initiate 5ARI therapy due to the potential for sexual dysfunction . In nearly all studies conducted in this area to date, the assessment of sexual function has been restricted to the overall incidence of sexually‐related adverse events (AEs) reported spontaneously as part of regular clinical trial AE reporting .…”

National trends in surgical therapy for benign prostatic hyperplasia in Australia

“…The increase in surgical treatments is commensurate with the 70% increase in males aged over 65 years between 1997 and 2017 and is an explanation for the substantial increase in surgical therapies . Increased prostate cancer awareness in Australia (where men with urinary symptoms are encouraged to see a doctor) and increasing awareness that BPH symptoms, while related to aging, can be treated, may also be partially responsible …”