Abstract
Objectives: To identify the current practice among urologists in the evaluation and management of prostatic diseases, mainly benign prostatic hypertrophy (BPH) in the western region of the Kingdom of Saudi Arabia.
Design: A questionnaire was constructed and distributed to 40 urologists practicing in the different health sectors in the western region. The questionnaire contained 8 questions covering 15 related items. The questions aimed to collect information on the following: (1) The size and sector of the participating institutes; (2) The method used for prostatic symptoms' evaluation; (3) The routine practice of digital rectal examination (DRE) in the physical examination; (4) The urologists' estimation of the post-void residual volume of urine (PVRV) and its value in treatment selection; (5) The use of imaging for the evaluation of upper and lower urinary tracts; (6) The availability and use of prostatic specific antigen (PSA); (7) The availability and use of uroflowmetry and urodynamic studies and (8) The management modalities used.
Results: Thirty-two urologists (80%) answered the questionnaire. Only 8/32 (25%) are using a symptom score index; 32/32 (100%) routinely perform DRE during the physical examination; 23/32 (72%) are still using intravenous urography (IVU) in the evaluation, 29/32 (91%) consider PVRV of urine important in the selection of management modality and 27/32 (84%) are routinely estimating it in the work-up for prostatic enlargement. There was an alarmingly high percent of answers indicating non availability of trans-rectal ultrasonography (TRUS), PSA, uroflowmetry and other urodynamic studies. The 3 most commonly used management modalities for benign prostatic hypertrophy (BPH) are 5 alpha reductase enzyme inhibitor, alpha sympathetic blockade and trans-urethral resection of the prostate (TRUP). Conclusion: The survey served to highlight the areas of weaknesses and deficiencies that need collaborative efforts to rectify in order to improve our medical care in this particular area. The findings of this study emphasize the value of standardizing and updating the steps of clinical methods in the evaluation and management of certain diseases.