SURVEY OF UROLOGICAL CENTERS AND REVIEW OF THE CURRENT PRACTICE IN THE EVALUATION AND TREATMENT OF PROSTATIC DISEASE IN THE KINGDOM OF SAUDI-ARABIA

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.