The Canadian Benign Prostatic Hyperplasia Audit Study (CanBas).
OBJECTIVE
To determine the prevalence, diagnostic patterns and management of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) in Canadian urology outpatient practice.


METHODS
Representative urologists were randomly selected from lists provided by the Canadian and Quebec Urological Associations. Each patient identified with a BPH diagnosis during a typical 2-consecutive-week period during April, May or June 2007 was asked to complete a corresponding International Prostate Symptom Score (IPSS) questionnaire. Each day, the participant urologist completed an outpatient log and a detailed programmed chart review to transcribe demographics, investigations and treatments associated with each BPH patient.


RESULTS
Eighty-six urologists were invited to participate. Thirty-eight (44.2%) agreed, and 27 of those (71.1%) submitted evaluable data for the audit. Of the 5616 patients seen in outpatient practice (average 208 per urologist), 4324 (77%) were male. A BPH diagnosis was identified in 19.6% of the men (n = 849; mean age 69.5, standard deviation [SD] 10, yr; age range 40-100 yr; mean duration of symptoms 4.8, SD 4.2, yr; mean IPSS score 12.3, SD 7.4; mean prostate specific antigen [PSA] 3.9, SD 3.9, ng/mL). Twenty-four percent of patients had prostates that were rated as large, 50% as medium and 26% as small. PSA level correlated positively with prostate volume. Twenty-two percent were initial consultations for LUTS and 78% were repeat visits. Diagnostic evaluation tended to follow those examinations and tests recommended by the Canadian BPH guidelines. Treatment choices tended to follow an evidence-based algorithm with respect to treatment choices for men in the various prostate-volume and PSA groups.


CONCLUSIONS
This prospective audit indicates that BPH remains a common condition managed by urologists in outpatient practice. Investigations and treatments confirm that Canadian urologists appear to be following Canadian BPH guidelines as well as the most recent evidence from the literature.
Nickel
J Curtis
JC
Queen's University, Kingston, Ont., the.
Downey
Joe
J
Bénard
Francois
F
Chetner
Michael
M
Grantmyre
John
J
So
Alan
A
Whelan
Paul
P
J Urol. 2008 Feb;179(2):616-21; discussion 621
18082216
J Urol. 2000 Feb;163(2):499-502
10647665
Can J Urol. 2005 Jun;12(3):2677-83
16011814
Can J Urol. 2004 Apr;11(2):2186-93
15182407
N Engl J Med. 2003 Dec 18;349(25):2387-98
14681504
Eur Urol. 2003 Oct;44(4):461-6
14499682
Can Urol Assoc J. 2008 Feb;2(1):16-21
18542722
Urology. 1999 Oct;54(4):662-9
10510925
J Urol. 2003 Aug;170(2 Pt 1):530-47
12853821
N Engl J Med. 1998 Feb 26;338(9):557-63
9475762
Urology. 1999 Mar;53(3):473-80
10096369
BJU Int. 2006 Apr;97 Suppl 2:7-11; discussion 21-2
16507046