Underdetection of clinical benign prostatic hyperplasia in a general medical practice

Abstract

OBJECTIVE: To measure detection of clinical benign prostatic hyperplasia (BPH) in a general medicine practice. DESIGN: Self-administered questionnaire and retrospective ambulatory medical record review. SETTING: Hospital-based general medicine practice. PATIENTS: Two hundred and four men aged 50 years and older. MEASUREMENTS AND MAIN RESULTS: Clinical information was obtained from a self-administered questionnaire containing the American Urological Association symptom index and the BPH Impact Index bother scale, and from retrospective review of ambulatory medical records for the previous 24 months. Thirty percent of patients had moderate to severe urinary tract symptoms, and 67% of these individuals were bothered by the symptoms. Only 52% with moderate to severe symptoms recalled any discussion with their primary care physician about their symptoms. There was medical record documentation of a review of urinary tract symptoms in only 18% and a prostate examination in only 64%. Patients with more symptoms and bother tended to recall a discussion of urinary tract symptoms with their physician. However, moderate to severe symptoms and bother were not associated with increased documentation of a history of urinary tract symptoms or prostate examination. CONCLUSIONS: Clinical BPH was underdetected in a general medicine practice. Because many men do not complain to their physicians about urinary tract symptoms and reduced quality of life, perhaps primary care physicians should pay more attention to recognizing this common condition of older men.