title: Benign prostatic hyperplasia evaluation and management by urologists and primary care physicians: practice patterns from the observational BPH registry.
abstract: OBJECTIVE
  We examined the evaluation of and management for lower urinary tract symptoms/benign prostatic hyperplasia by physician specialty (urologist vs primary care physician).
  
  
  METHODS
  The BPH Registry and Patient Survey is a longitudinal, observational, disease registry cohort of patients enrolled from January 2004 to February 2005 in the United States. The survey examines patient outcomes and physician practice patterns in the management of lower urinary tract symptoms associated with clinical benign prostatic hyperplasia. It includes 402 urologist and primary care physician practices throughout the United States. Included in this study were 6,924 men with lower urinary tract symptoms/benign prostatic hyperplasia managed by watchful waiting or medical therapy. Data were collected on demographics, clinical characteristics and lower urinary tract symptoms/benign prostatic hyperplasia management using physician and patient completed forms. Multivariate analysis was done by physician specialty.
  
  
  RESULTS
  Based on multivariate analysis urologists were more likely than primary care physicians to perform urinalysis (OR 3.9), serum prostate specific antigen (OR 1.2) and post-void residual urine (OR 18.9) measurement, uroflowmetry (OR 17.3), prostate ultrasound (OR 7.7) and biopsy (OR 3.5), renal ultrasound (OR 4.0) and cystoscopy (OR 4.6) but less likely to measure creatinine (OR 0.1). Men seeing urologists were twice as likely as men seeing primary care physicians to be treated with benign prostatic hyperplasia medical therapy vs watchful waiting. Significant differences by physician specialty were also observed for specific benign prostatic hyperplasia medical therapies.
  
  
  CONCLUSIONS
  Significant differences in practice patterns were observed between primary care physicians and urologists in the evaluation of and management for lower urinary tract symptoms/benign prostatic hyperplasia. These data establish valuable benchmarks and identify possible interventions that may improve the standard of care.
authors.affiliation: Department of Urology, University of Michigan and i3 Drug Safety, Ann Arbor, Michigan 48109-2800, USA. Jtwei@umich.edu
authors.forename: John T
authors.initials: JT
authors.lastname: Wei
authors.forename: Martin M
authors.initials: MM
authors.lastname: Miner
authors.forename: William D
authors.initials: WD
authors.lastname: Steers
authors.forename: Raymond C
authors.initials: RC
authors.lastname: Rosen
authors.forename: Allen D
authors.initials: AD
authors.lastname: Seftel
authors.forename: David J
authors.initials: DJ
authors.lastname: Pasta
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Carman
authors.forename: Claus G
authors.initials: CG
authors.lastname: Roehrborn
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000175:diagnosis* / Q000628:therapy*; D053448:Prostatism / Q000175:diagnosis* / Q000628:therapy*; D012042:Registries; D014572:Urology