Portal de Periódicos da CAPES

Benign prostatic hyperplasia evaluation, treatment and association with sexual dysfunction: practice patterns according to physician specialty

2008; Wiley; Volume: 62; Issue: 4 Linguagem: Inglês

10.1111/j.1742-1241.2008.01699.x

1742-1241

A D Seftel, R. Rosen, Matt T. Rosenberg, Richard Sadovsky,

Sexual function and dysfunction studies

International Journal of Clinical PracticeVolume 62, Issue 4 p. 614-622 Benign prostatic hyperplasia evaluation, treatment and association with sexual dysfunction: practice patterns according to physician specialty A. D. Seftel, A. D. Seftel Department of Urology, Case Medical Center/University Hospitals of Cleveland, Cleveland, OH, USASearch for more papers by this authorR. C. Rosen, R. C. Rosen New England Research Institutes, Watertown, MA, USASearch for more papers by this authorM. T. Rosenberg, M. T. Rosenberg Mid-Michigan Health Centers, Jackson, MI, USASearch for more papers by this authorR. Sadovsky, R. Sadovsky Department of Family Practice, Kings County Hospital Center, State University of New York Health Science Center, Brooklyn, NY, USASearch for more papers by this author A. D. Seftel, A. D. Seftel Department of Urology, Case Medical Center/University Hospitals of Cleveland, Cleveland, OH, USASearch for more papers by this authorR. C. Rosen, R. C. Rosen New England Research Institutes, Watertown, MA, USASearch for more papers by this authorM. T. Rosenberg, M. T. Rosenberg Mid-Michigan Health Centers, Jackson, MI, USASearch for more papers by this authorR. Sadovsky, R. Sadovsky Department of Family Practice, Kings County Hospital Center, State University of New York Health Science Center, Brooklyn, NY, USASearch for more papers by this author First published: 06 March 2008 https://doi.org/10.1111/j.1742-1241.2008.01699.xCitations: 20 Allen D. Seftel, MD,Case Medical Center/University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, OH 44106-5046, USATel.: + 1 216 844 7728Fax: + 1 216 844 1900Email: [email protected] DisclosuresA. D. Seftel: consultant to Lilly, Pfizer, Auxilium, Indevus, sanofi-aventis and Solvay. R. C. Rosen: consultant to sanofi-aventis. M.T. Rosenberg: consultant to Astellas, GSK, Novartis, sanofi-aventis, Ortho-McNeil, Pfizer and Verathon; speaker for Astella, GSK, Ortho-McNeil and Verathon; research funding from sanofi-aventis and Ortho-McNeil. R. Sadovsky: none. [Correction added after the online publication, 21st February 2008, where the following statement was omitted from the Disclosure section] As Urology Section Editor for the Journal, Matt T. Rosenberg withdrew from the review process and deferred all editorial decisions to Graham Jackson. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Summary Aims: Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) are a common problem in ageing men and are accompanied by sexual dysfunction (SD) in 40–70% of men evaluated in large-scale epidemiological studies. One year after the 2003 American Urological Association (AUA) guideline on BPH management was published, a survey of US urologists (UROs) and primary care physicians (PCPs) was conducted to ascertain physician knowledge of the AUA guideline and practice patterns regarding LUTS/BPH diagnosis, treatment and association with SD. Methods: A 19-question qualitative survey, sponsored by the American Foundation of Urologic Disease, was mailed April 2004 to 7500 UROs and 17,500 PCPs, with responses collected until May 2004. Results: A total of 788 surveys were returned (437 UROs; 351 PCPs). Only 62% of PCPs were aware of and only 41% of PCPs used the AUA-Symptom Index/International Prostate Symptom Score (AUA-SI/IPSS) to assess LUTS compared with 97% and 81% of UROs respectively. Alpha-blocker monotherapy was the treatment of choice for both UROs and PCPs. Compared with UROs, PCPs reported higher rates of SD in association with LUTS or BPH (37% vs. 27%) and BPH pharmacotherapy (27% vs. 21%). UROs and PCPs reported higher rates of SD side effects [ejaculatory dysfunction (EjD) and erectile dysfunction (ED)] for tamsulosin (EjD: UROs 22%, PCPs 12%; ED: UROs 7%, PCPs 10%) and doxazosin (EjD: UROs 14%, PCPs 10%; ED: UROs 7%, PCPs 12%) than for alfuzosin (EjD: UROs 6%, PCPs 4%; ED: UROs 4%, PCPs 5%). Conclusions: The results suggest that many PCPs are not using the AUA-SI/IPSS to assess LUTS in their ageing male patients. Both UROs and PCPs appear to be underestimating the prevalence of SD in men with LUTS/BPH relative to prevalence rates reported in large-scale epidemiological studies. References 1 Berry SJ, Coffey DS, Walsh PC et al. The development of human benign prostatic hyperplasia with age. J Urol 1984; 132: 474– 9. 2 Holtgrewe HL, Bay-Nielsen H, Carlsson P et al. The economics of the management of lower urinary tract symptoms and benign prostatic hyperplasia. In: L Denis, K Griffiths, S Khoury, ATK Cockett, J McConnell, C Chatelain, G Murphy, O Yoshida, eds. Proceedings of the 4th International Consultation on Benign Prostatic Hyperplasia (BPH). Plymouth, UK: Health Publication Ltd, 1998: 61– 81. 3 Baine WB, Yu W, Summe JP et al. Epidemiologic trends in the evaluation and treatment of lower urinary tract symptoms in elderly male Medicare patients from 1991 to 1995. J Urol 1998; 160: 816– 20. 4 Sarma AV, Jacobson DJ, McGree ME et al. A population based study of incidence and treatment of benign prostatic hyperplasia among residents of Olmsted County, Minnesota: 1987 to 1997. J Urol 2005; 173: 2048– 53. 5 AUA Practice Guidelines Committee. AUA guideline on management of benign prostatic hyperplasia. Chapter 1: diagnosis and treatment recommendations. J Urol 2003; 170: 530– 47. 6 Braun MH, Sommer F, Haupt G et al. Lower urinary tract symptoms and erectile dysfunction: co-morbidity or typical "Aging Male" symptoms? Results of the "Cologne Male Survey" Eur Urol 2003; 44: 588– 94. 7 Blanker MH, Bohnen AM, Groeneveld FP et al. Correlates for erectile and ejaculatory dysfunction in older Dutch men: a community-based study. J Am Geriatr Soc 2001; 49: 436– 42. 8 Nicolosi A, Glasser DB, Moreira ED et al. Prevalence of erectile dysfunction and associated factors among men without concomitant diseases: a population study. Int J Impot Res 2003; 15: 253– 7. 9 Rosen R, Altwein J, Boyle P et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol 2003; 44: 637– 49. 10 Leliefeld HH, Stoevelaar HJ, McDonnell J. Sexual function before and after various treatments for symptomatic benign prostatic hyperplasia. BJU Int 2002; 89: 208– 13. 11 Vallancien G, Emberton M, Harving N et al. Sexual dysfunction in 1,274 European men suffering from lower urinary tract symptoms. J Urol 2003; 169: 2257– 61. 12 Namasivayam S, Minhas S, Brooke J et al. The evaluation of sexual function in men presenting with symptomatic benign prostatic hyperplasia. Br J Urol 1998; 82: 842– 6. 13 Frankel SJ, Donovan JL, Peters TI et al. Sexual dysfunction in men with lower urinary tract symptoms. J Clin Epidemiol 1998; 51: 677– 85. 14 Baniel J, Israilov S, Shmueli J et al. Sexual function in 131 patients with benign prostatic hyperplasia before prostatectomy. Eur Urol 2000; 38: 53– 8. 15 Tubaro A, Polito M, Giambroni L et al. Sexual function in patients with LUTS suggestive of BPH. Eur Urol 2001; 40 (Suppl. 1): 19– 22. 16 Brookes ST, Donovan JL, Peters TJ et al. Sexual dysfunction in men after treatment for lower urinary tract symptoms: evidence from randomised controlled trial. BMJ 2002; 324: 1059– 61. 17 AUA. AUA guideline on the management of benign prostatic hyperplasia. J Urol 2003; 170: 530– 47. 18 Carbone DJ Jr, Hodges S. Medical therapy for benign prostatic hyperplasia: sexual dysfunction and impact on quality of life. Int J Impot Res 2003; 15: 299– 306. 19 FLOMAX (tamsulosin hydrochloride) (prescribing information). Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc., 2006. 20 Narayan P, Lepor H. Long-term, open-label, phase III multicenter study of tamsulosin in benign prostatic hyperplasia. Urology 2001; 57: 466– 70. 21 Roehrborn CG, Van Kerrebroeck P, Nordling J. Safety and efficacy of alfuzosin 10 mg once-daily in the treatment of lower urinary tract symptoms and clinical benign prostatic hyperplasia: a pooled analysis of three double-blind, placebo-controlled studies. BJU Int 2003; 92: 257– 61. 22 Van Kerrebroeck P, Jardin A, Van Cangh P et al. Long-term safety and efficacy of a once-daily formulation of alfuzosin 10 mg in patients with symptomatic benign prostatic hyperplasia: open-label extension study. Eur Urol 2002; 41: 54– 60, discussion 60-1. 23 Roehrborn CG. Efficacy and safety of once-daily alfuzosin in the treatment of lower urinary tract symptoms and clinical benign prostatic hyperplasia: a randomized, placebo-controlled trial. Urology 2001; 58: 953– 9. 24 PROSCAR (finasteride) tablets (prescribing information). Whitehouse Station, NJ: Merck & Co., Inc., 2004. 25 HYTRIN (terazosin HCl) capsules (prescribing information). North Chicago, IL: Abbott Laboratories, 2001. 26 Nickel JC, Fradet Y, Boake RC et al. Efficacy and safety of finasteride therapy for benign prostatic hyperplasia: results of a 2-year randomized controlled trial (the PROSPECT study). PROscar Safety Plus Efficacy Canadian Two year Study. CMAJ 1996; 155: 1251– 9. 27 Roehrborn CG, Boyle P, Nickel JC et al. Efficacy and safety of a dual inhibitor of 5-alpha-reductase types 1 and 2 (dutasteride) in men with benign prostatic hyperplasia. Urology 2002; 60: 434– 41. 28 Ansong KS, Lewis C, Jenkins P et al. Help-seeking decisions among men with impotence. Urology 1998; 52: 834– 7. 29 Mirone V, Gentile V, Zizzo G et al. Did men with erectile dysfunction discuss their condition with partner and physicians? A survey of men attending a free call information service Int J Impot Res 2002; 14: 256– 8. 30 Kitai E, Vinker S, Kijner F et al. Erectile dysfunction – the effect of sending a questionnaire to patients on consultations with their family doctor. Fam Pract 2002; 19: 247– 50. 31 Kubin M, Wagner G, Fugl-Meyer AR. Epidemiology of erectile dysfunction. Int J Impot Res 2003; 15: 63– 71. 32 Fisher W, Rosen R, Eardley I et al. The multinational Men's Attitudes to Life Events and Sexuality (MALES) Study Phase II: understanding PDE5 inhibitor treatment seeking patterns among men with erectile dysfunction. J Sex Med 2004; 1: 150– 60. 33 Kaplan S, Naslund M. Public, patient, and professional attitudes towards the diagnosis and treatment of enlarged prostate; a landmark national US survey. Int J Clin Pract 2006; 60: 1157– 65. 34 Seftel A, Rosen R, Kuritzky L. Physician perceptions of sexual dysfunction related to benign prostatic hyperplasia (BPH) symptoms and sexual side effects related to BPH medications. Int J Impot Res 2007; 19: 386– 92. 35 Fawzy A, Fontenot C, Guthrie R et al. Practice patterns among primary care physicians in benign prostatic hyperplasia and prostate cancer. Fam Med 1997; 29: 321– 5. 36 Collins MM, Barry MJ, Bin L et al. Diagnosis and treatment of benign prostatic hyperplasia. Practice patterns of primary care physicians. J Gen Intern Med 1997; 12: 224– 9. 37 Plawker MW, Fleisher JM, Nitti VW et al. Primary care practitioners: an analysis of their perceptions of voiding dysfunction and prostate cancer. J Urol 1996; 155: 601– 4. 38 Rosenberg MT. The sad, misunderstood prostate: understanding perceptions and reality. Int J Clin Pract 2006; 60: 1148– 9. 39 Read S, King M, Watson J. Sexual dysfunction in primary medical care: prevalence, characteristics and detection by the general practitioner. J Public Health Med 1997; 19: 387– 91. 40 Baldwin K, Ginsberg P, Harkaway RC. Under-reporting of erectile dysfunction among men with unrelated urologic conditions. Int J Impot Res 2003; 15: 87– 9. 41 Perelman MA. Sex coaching for physicians: combination treatment for patient and partner. Int J Impot Res 2003; 15 (Suppl. 5): S67– 74. 42 Fogler R, Shibata K, Horie K et al. Use of recombinant alpha1-adrenoceptors to characterize subtype selectivity of drugs for the treatment of prostatic hypertrophy. Eur J Pharmacol 1995; 288: 201– 7. 43 Hellstrom WJ, Sikka SC. Effects of acute treatment with tamsulosin versus alfuzosin on ejaculatory function in normal volunteers. J Urol 2006; 176: 1529– 33. 44 Martin DJ, Lluel P, Pouyet T et al. Relationship between the effects of alfuzosin on rat urethral and blood pressures and its tissue concentrations. Life Sci 1998; 63: 169– 76. 45 Mottet N, Bressolle F, Delmas V et al. Prostatic tissual distribution of alfuzosin in patients with benign prostatic hyperplasia following repeated oral administration. Eur Urol 2003; 44: 101– 5. 46 Martin DJ. Preclinical pharmacology of alpha1-adrenoceptor antagonists. Eur Urol 1999; 36: 35– 41, discussion 65. 47 McConnell JD, Roehrborn CG, Bautista OM et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med 2003; 349: 2387– 98. 48 AUA Practice Guidelines Committee. American Urological Association. AUA Guideline on Management of Benign Prostatic Hyperplasia. Chapter 3: Results of the Treatment Outcomes Analyses. http://www.AUAnet.org (accessed March 2007). Citing Literature Volume62, Issue4April 2008Pages 614-622 ReferencesRelatedInformation