Ham. Mosli, SURVEY OF UROLOGICAL CENTERS AND REVIEW OF THE CURRENT PRACTICE IN THE EVALUATION AND TREATMENT OF PROSTATIC DISEASE IN THE KINGDOM OF SAUDI-ARABIA, Saudi medical journal, 17(6), 1996, pp. 718-725
Objectives: To identify the current practice among urologists in the e
valuation and management of prostatic diseases, mainly benign prostati
c hypertrophy (BPH) in the western region of the Kingdom of Saudi Arab
ia. Design: A questionnaire was constructed and distributed to 40 urol
ogists practicing in the different health sectors in the western regio
n. The questionnaire contained 8 questions covering 15 related items.
The questions aimed to collect information on the following: (1) The s
ize and sector of the participating institutes; (2) The method used fo
r prostatic symptoms' evaluation; (3) The routine practice of digital
rectal examination (DRE) in the physical examination; (4) The urologis
ts' estimation of the post-void residual volume of urine (PVRV) and it
s value in treatment selection; (5) The use of imaging for the evaluat
ion of upper and lower urinary tracts; (6) The availability and use of
prostatic specific antigen (PSA); (7) The availability and use of uro
flowmetry and urodynamic studies and (8) The management modalities use
d. Results: Thirty-two urologists (80%) answered the questionnaire. On
ly 8/32 (25%) are using a symptom score index; 32/32 (100%) routinely
perform DRE during the physical examination; 23/32 (72%) are still usi
ng intravenous urography (IVU) in the evaluation, 29/32 (91%) consider
PVRV of urine important in the selection of management modality and 2
7/32 (84%) are routinely estimating it in the work-up for prostatic en
largement. There was an alarmingly high percent of answers indicating
non availability of trans-rectal ultrasonography (TRUS), PSA, uroflowm
etry and other urodynamic studies. The 3 most commonly used management
modalities for benign prostatic hypertrophy (BPH) are 5 alpha reducta
se enzyme inhibitor, alpha sympathetic blockade and trans-urethral res
ection of the prostate (TRUP). Conclusion: The survey served to highli
ght the areas of weaknesses and deficiencies that need collaborative e
fforts to rectify in order to improve our medical care in this particu
lar area. The findings of this study emphasize the value of standardiz
ing and updating the steps of clinical methods in the evaluation and m
anagement of certain diseases.