[The prostate: how to treat this symbol of male vulnerability? An Association Française d'Urologie (AFU)-IPSOS qualitative survey].
BACKGROUND
Information on prostate diseases, including prostate cancer, has been promoted by the Association Française d'Urologie (AFU) for several years, but is developing slowly in France. In 2005, a first communication was targeted to the male public and identified the reasons for the fatalistic attitude of men, and paradoxically, why the prostate incarnates the vulnerability of their sexual capital. As part of a second phase, this article presents the results of a complementary study conducted among general practitioners to identify their expectations and the most appropriate levers to promote screening.


METHODS
The Ipsos survey company developed a Krisis qualitative protocol in October 2005 (after the first French prostate day on 15 September 2005). Three groups of general practitioners were defined: doctors who are very active in terms of screening, doctors who are uncomfortable with this problem and doctors who systematically refer their patients to urologists.


RESULTS
The management of prostate diseases often highlights the ageing process for the patient. The ability to discuss these problems during the consultation depended on the doctor's degree of comfort with this subject, which is related to his/her training and relationships with urologists. To initiate the question of screening, general practitioners involved in this process asked simple questions about everyday practices without being afraid of making jokes or basing their approach on mediatization of the disease. Digital rectal examination is one of the important clinical elements but is not always easy to perform. PSA was found to be an examination that is not always appropriate, characterized by a lack of information on the conditions for ordering this test, its usefulness and its relevance for screening. Ultrasound could be a way of alerting the patient without dramatizing the situation, letting the urologist perform digital rectal examination. Female general practitioners preferred PSA and ultrasound. The doctors surveyed relied on mediatization of prostate diseases, a high level of interactivity with urologists and documents and brochures to be placed in waiting rooms to relay screening messages.


CONCLUSIONS
General practitioners need their authorities, specialists and public health institutions to develop and mediatize andrology in the same way as gynaecology. Urologists play a major supportive role by means of conferences, postgraduate training or AFU invitations.
Yves
Bardon
B
ybkrisis@ipsos.com
de la Taille
Alexandre
A
Chartier-Kastler
Emmanuel
E
Moreau
Jean-Luc
JL
Davin
Jean-Louis
JL
Mignard
Jean-Pierre
JP
Coulange
Christian
C
Allegre
Jean-Paul
JP
Averous
Michel
M
Botto
Henry
H
Coloby
Patrick
P
Conort
Pierre
P
Delmas
Vincent
V
Desgrandchamps
François
F
Fourcade
Richard-Olivier
RO
Grall
Jérôme
J
Grise
Philippe
P
Kouri
Georges
G
Le Doze
Hervé
H
Piechaud
Thierry
T
Prunet
Denis
D
Rambeaud
Jean-Jacques
JJ
Rebillard
Xavier
X
Soulie
Michel
M
Vignes
Benoît
B
Villers
Arnauld
A
D000375:Aging / Q000502:physiology; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003142:Communication; D051517:Digital Rectal Examination; D005194:Family Practice / Q000193:education; D005260:Female; D005602:France; D006266:Health Education; D006293:Health Promotion; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008403:Mass Screening; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D017430:Prostate-Specific Antigen / Q000032:analysis; D011469:Prostatic Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011634:Public Health; D012017:Referral and Consultation; D014463:Ultrasonography; D014572:Urology
D017430:Prostate-Specific Antigen