Identifying the Knowledge Gaps About BPH Among Male Urology

Identifying the knowledge gaps about BPH among Male Urology patients.

<h2 id=" Objective">Objective:</h2><p>To evaluate knowledge of benign prostatic hyperplasia (BPH) and identify factors associated with knowledge deficits among men newly presenting to a urology clinic.</p><h2 id="Methods">Methods:</h2><ul><li>Adult male patients visiting for an initial evaluation at urology clinic, were invited to complete a 26-item multiple-choice questionnaire, irrespective of their presenting complaint.</li><li>The survey assessed general knowledge of BPH, related symptomatology, and treatment options prior to their initial consultation.</li><li>Responses were analyzed in relation to demographic variables using analysis of variance (ANOVA) and multivariable linear regression.</li></ul><h2 id="Results">Results:</h2><ul><li>A total of 206 patients completed the questionnaire.</li><li>The mean age was 60.8 years, with the majority identifying as white (85.6%) and 28.9% covered by Medicare or Medicaid.</li><li>The overall mean score was 62% (Standard Deviation 22.9%), with the lowest scores observed in the domain related to BPH complications.</li><li>Significantly higher knowledge scores were associated with having a graduate or professional degree (P&lt; .0Ol)and being self-referred(P=.027)(Table 1).</li></ul><p style="text-align:center;"><img src="https://cdn.megawecare.com/GHBY/Internal-Images/Multivariable_model_for_questions_answered_Correctly.webp" alt="Multivariable model for % of questions answered correctly" width="876" height="376"></p><h2 id="Discussion">Discussion:</h2><ul><li>It is challenging for patients suffering with BPH to identify that there is a problem and that they should seek care since the symptoms of BPH are insidious in onset and/or normalized in society.</li><li>With the exponential growth and change in the treatment landscape of BPH over the past decade, a patient with BPH might be considering multiple procedures in addition to combinations of medical therapy.</li><li>Effective decision making for BPH treatment needs a basic understanding of BPH pathophysiology and sequela for patients, poor patient understanding of their chronic disease condition has been consistently associated with adverse health outcomes.</li><li>Studies in urology have shown, limited patient understanding of treatment options and disease progression has been associated with lower adoption of active surveillance and increased treatment regret in prostate cancer, as well as longer hospital stays and higher risk of pathological upstaging in patients undergoing radical cystectomy.</li><li>Survey published in 2006 asked American patients with BPH about the most significant long-term consequence of BPH. Only 6% who identified acute urinary retention while over half of men reported the development of prostate cancer as the greatest concern.</li><li>Other surveys of BPH patients have observed that patients are most interested in avoiding a surgical procedure compared to achieving immediate improvement in their symptoms.</li><li>This study results identified level of education and non-MD referral as two predictors for correctly answering survey questions.</li><li>Findings of the current study pose a key question: will they be able to make an informed decision when selecting between observation, medical management, MISTs, and surgery during a 15-minute clinic visit, if they do not understand the basics of BPH.</li><li>Even when current initiatives have focused on decision aids to help patients select the ideal surgical treatment only few instruments have been developed to improve awareness of the natural history of BPH.</li><li>Given its epidemiology, many patients not already diagnosed with BPH and regardless of chief complaint, will likely develop new or worsening LUTS as they age.</li><li>This study highlights the lack of awareness of BPH as a cause of LUTS.</li></ul><h2 id="Conclusion">Conclusion</h2><ul><li>Significant gaps exist about knowledge of BPH and the consequences of disease progression among men seeking urologic care for the first time.</li><li>Less formal education and those referred by another healthcare Provider have more pronounced deficiency in BPH knowledge.</li><li>These results provide a framework within which healthcare providers must counsel men regarding LUTS.</li><li>Study also highlight the need for additional resources to help patients navigate the increasing complexities of BPH treatment.</li></ul>

Urology Update   Issue 4   2025

<ul><li><a href="#Objective">Objective</a></li><li><a href="#Methods">Methods</a></li><li><a href="#Results">Results</a></li><li><a href="#Discussion">Discussion</a></li></ul>