Identifying patients with benign prostatic hyperplasia through a diagnosis of, or treatment for, erectile dysfunction.
OBJECTIVE
Erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) associated with benign prostate hyperplasia (BPH) are highly correlated. This study examined rates of screening, diagnosis, and treatment of BPH/LUTS among men seeking care for ED.


METHODS
This was a retrospective US claims data analysis (1999-2004) evaluating men > or = 40 years old with a new diagnosis of or prescription medication for ED. Multivariate analyses were used to examine times to screening, diagnosis, and treatment.


RESULTS
81 659 men with ED were identified (mean age 57 years). The baseline prevalence of recorded BPH was 1.5%. During the follow-up period (mean 2.2 years), 7.6% had documented BPH. Time to screening was shorter among patients seeing urologists (121.1 days) compared with those seeing primary-care physicians (282.2 days). Controlling for demographic and clinical characteristics, patients who saw a urologist were more likely to be screened (OR: 2.4, p < 0.0001), diagnosed with BPH (OR: 1.8, p < 0.0001), and treated (OR: 1.3, p < 0.0001), relative to patients seeing other providers. Men aged 75 and over were 43% less likely to be screened (p < 0.0001), but 5.4 times more likely to be diagnosed with BPH (p < 0.0001) and 5.3 times more likely to be treated (p < 0.0001) compared with men aged 40-49.


CONCLUSIONS
Screening for BPH appears less likely for men with ED who do not see a urologist. When screening does occur, it takes much longer with non-specialty providers. Patient age and provider specialty are key factors associated with screening, diagnosis, and treatment of BPH among men with ED.
McVary
Kevin
K
Department of Urology, Feinberg School of Medicine, Northwestern University School of Medicine, Chicago, IL 60611, USA. k-mcvary@northwestern.edu
Foley
Kathleen A
KA
Long
Stacey R
SR
Sander
Stephen
S
Curtice
Tammy G
TG
Shah
Hemal
H
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D007172:Erectile Dysfunction / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D007345:Insurance Claim Review; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011470:Prostatic Hyperplasia / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014555:Urination Disorders / Q000175:diagnosis* / Q000188:drug therapy
D000317:Adrenergic alpha-Antagonists