With the introduction of novel treatment options for benign prostatic hyperplasia (BPH), decision making regarding surgical management has become ever more complex. Factors such as clinical exposure, equipment availability, patient characteristics and hospital setting may affect what treatment is offered and an informed patient choice. The aim of this study was to investigate how urologists help patients make decisions regarding BPH management and whether their practice would differ if they were the patient themselves.
A 52-question survey presenting hypothetical clinical scenarios was distributed to European urologists and trainees/residents online and in person. In each scenario, regarding treatment options for BPH, the participant considered themselves firstly as the treating clinician and secondly as the patient themselves. Details regarding the participants' clinical experience, awareness of treatment options and exposure to these options were obtained.
There were 139 participants; 69.8% of whom were consultants, with 82.1% of participants having practiced urology for more than 5 years. A total of 59.7% of urologists consider themselves BPH specialists. Furthermore, 93.5% of those surveyed had performed transurethral resection of the prostate (TURP), whilst procedures performed the least by participants were minimally invasive surgical therapy (MIST) options. Only 17.3% had seen and 1.4% had performed all of the treatment options. When considering themselves as a patient within standard practice, there was a preference for HoLEP amongst participants.
The majority of urologists surveyed had minimal experience to newer BPH techniques and MIST, suggesting that more exposure is required. A higher rate of HoLEP was chosen as a treatment option for urologists themselves as a patient than what they would choose as an option for their patients.
Central European journal of urology. 2024 Apr 01 [Epub]
Holly Colvin, Max Johnston, Francesco Ripa, Mriganka Mani Sinha, Amelia Pietropaolo, James Brewin, Christian Fiori, Ali Gozen, Bhaskar K Somani
Urology trainee, Salisbury NHS Foundation Trust, Salisbury, United Kingdom., Consultant Urological Surgeon, Salisbury NHS Foundation Trust, Salisbury, United Kingdom., Urology trainee, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom., Consultant Urological Surgeon, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom., Consultant Urological Surgeon, Department of Oncology, Division of Urology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy., Consultant Urological Surgeon, Department of Urology, Medius Kliniken, Ruit, Baden-Württemberg, Germany.