title: Diagnosis of BPH and treatment of LUTS among GPs: a European survey.
abstract: OBJECTIVE
  This survey was conducted in France, Germany, Italy, Spain and UK, with the aim to assess diagnosis and therapy of BPH patients in clinical practice.
  
  
  METHODS
  A selected cohort of 455 general practitioners (GPs) in Europe were asked to report information on BPH patients with lower urinary tract symptoms (LUTS), including patient characteristics, diagnostic procedures, severity of illness, symptoms duration and underlying conditions. The GPs provided data relating to 886 patients.
  
  
  RESULTS
  The diagnostic work-up included description of symptoms (74.9-85.1%), rectal examination (55.4-82.1%) and the determination of PSA (79.1-94.7%). Transrectal sonography was popular in Italy and France (51.1% and 55.9%, respectively), less so in Germany (15.3%) and Spain (13.1%) and not at all in the UK (2.3%). At diagnosis, the most common symptom was nocturia (71-88%), followed by frequency (15-79%), urgency (43-68%) and weak stream (47-64%). The most common combination was the triad nocturia-frequency-feeling of incomplete emptying (22-31%). The mean ± SD LUTS severity score was similar in all countries: The main aim of treatment was the resolution of nocturia, which had an average score that reflected an important need (> 3.5) closely followed by frequency (3.3-3.9).
  This survey has shown that the most common LUTS is nocturia. Analyses of the symptoms' pattern revealed that the most common combination appears to be the triad nocturia-frequency-feeling of incomplete emptying. An association between LUTS and heart disease, diabetes and hypertension suggests that the pharmacological treatment should be devoid of effects on the cardiovascular system. With alpha blockers as first line treatment of LUTS, respondents were more concerned with hypotensive episodes resulting in falls, rather than about other typical side effects (e.g. ejaculation disorders and lowered libido). The survey highlights educational needs in diagnostics.
authors.affiliation: Department of Urology, University Vita-Salute, San Raffaele Hospital Department of Pathology, Scientific Institute Hospital San Raffaele, Milan, Italy IMS SpA, Milano, Italia. montorsi.francesco@hsr.it
authors.forename: F
authors.initials: F
authors.lastname: Montorsi
authors.forename: D
authors.initials: D
authors.lastname: Mercadante
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005060:Europe; D058006:General Practice / Q000706:statistics & numerical data*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000175:diagnosis*; D061665:Time-to-Treatment