Mf. Mcnaughton et al., UNDERDETECTION OF CLINICAL BENIGN PROSTATIC HYPERPLASIA IN A GENERAL MEDICAL-PRACTICE, Journal of general internal medicine, 11(9), 1996, pp. 513-518
OBJECTIVE: To measure detection of clinical benign prostatic hyperplas
ia (BPH) in a general medicine practice. DESIGN: Self-administered que
stionnaire 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: Clini
cal information was obtained from a self-administered questionnaire co
ntaining the American Urological Association symptom index and the BPH
Impact Index bother scale, and from retrospective review of ambulator
y medical records for the previous 24 months. Thirty percent of patien
ts had moderate to severe urinary tract symptoms, and 67% of these ind
ividuals were bothered by the symptoms, Only 52% with moderate to seve
re symptoms recalled any discussion with their primary care physician
about their symptoms. There was medical record documentation of a revi
ew of urinary tract symptoms in only 18% and a prostate examination in
only 64%, Patients with more symptoms and bother tended to recall a d
iscussion of urinary tract symptoms with their physician, However, mod
erate to severe symptoms and bother were not associated with increased
documentation of a history of urinary tract symptoms or prostate exam
ination. CONCLUSIONS: Clinical BPH was underdetected in a general medi
cine practice. Because many men do not complain to their physicians ab
out urinary tract symptoms and reduced quality of life, perhaps primar
y care physicians should pay more attention to recognizing this common
condition of older men.