The Diagnosis and Treatment of Lower Urinary Tract

Authors: Júlio Fonseca Carlos Martins da Silva

Publish Date: 2015/02/24

Volume: 35, Issue: 1, Pages: 19-27

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Abstract

Two related studies were undertaken in Portugal The first was a survey of primary care family physicians regarding the management of LUTS/BPH The second was a crosssectional study of the records of patients with suspected or confirmed LUTS/BPH managed by the surveyed physiciansOne hundred and sixtythree physicians were surveyed between 16 June 2012 and 10 February 2013 and 2988 patients were identified mean age 68 years While 80  of physicians would order diagnostic tests for patients reporting symptoms only 25  would initiate treatment based on reported symptoms alone Only 1  would refer patients directly to a urologist for diagnosis and 75  would only refer patients after an inadequate response to treatment in the primary care setting Management practices varied according to physicians’ age and experience Nocturia was both the most common and the most bothersome symptom Erectile dysfunction was reported by 51  of patients and 81  had hypertension hypercholesterolaemia and/or diabetes mellitus Diagnosis and treatment of LUTS/BPH differed for older patients those with comorbidities and those with more severe nocturia at presentationPrimary care physicians in Portugal usually diagnose and treat patients with LUTS/BPH rather than refer them to a urologist Physicians’ age and experience and patients’ age comorbidities and symptom severity affect the management of LUTS/BPH in primary care in PortugalWe thank Simone Boniface of Springer Healthcare Communications and Raewyn Poole on behalf of Springer Healthcare Communications for medical writing assistance We also thank Ray Hill for assistance with postsubmission revisions on behalf of Springer Healthcare Communications All medical writing assistance was funded by Tecnimede SAJúlio Fonseca is a physician at the Department of Urology Hospital Beatriz Angelo Loures and British Hospital Lisbon Portugal He is an occasional unpaid lecturer in Tecnimedesponsored events Carlos Martins da Silva is an employee of the Department of Urology Hospital de S João Faculdade de Medicina do Porto Porto Portugal He has received consultant honoraria from Tecnimede

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