Centro de Salud San Andrés, Madrid, Spain.
Urology Department, University Clinic of Navarra, Pamplona, Spain.
Int J Clin Pract. 2020 Nov;74(11):e13602. doi: 10.1111/ijcp.13602. Epub 2020 Aug 16.
To describe the real-world demographic and clinical characteristics of patients with lower urinary tract symptoms (LUTS) as a result of benign prostatic hyperplasia (BPH) in Spain.
This observational, retrospective, multicentre study conducted in primary care and urology clinics in Spain included men aged ≥50 years diagnosed (≤8 years prior to study visit) with LUTS caused by BPH. The primary endpoint was demographic and clinical characteristics; secondary endpoints included disease progression and diagnostic tests across both healthcare settings.
A total of 670 patients were included (primary care: n = 435; urology: n = 235). Most patients had moderate/severe LUTS (74.6%) and prostate volume >30 cc (81.7%), with no differences between settings. More patients had prostate-specific antigen (PSA) ≥1.5 ng/mL in primary care (74.5%) versus urology (67.7%). Progression criteria were prevalent (48.9%). Clinical criteria were more commonly used than the International Prostate Symptom Score (IPSS) to evaluate LUTS at diagnosis (primary care: clinical criteria 73.0%; IPSS: 26.9%; urology: clinical criteria 76.5%; IPSS: 23.4%). Proportion of patients with moderate/severe LUTS at diagnosis was lower using clinical criteria than IPSS, and the proportion of patients with 'worsening' LUTS (diagnosis to study visit) was higher when using clinical criteria versus IPSS. In both healthcare settings, the most commonly used diagnostic tests were general and urological clinical history and PSA.
Demographic and clinical characteristics of patients with BPH in Spain were similar in primary care and urology; however, assessment criteria to evaluate LUTS severity differ and are not completely aligned with clinical guideline recommendations. Increased use of recommended assessments may enhance optimal BPH management.
描述西班牙良性前列腺增生（BPH）所致下尿路症状（LUTS）患者的真实世界人口统计学和临床特征。
本观察性、回顾性、多中心研究在西班牙的初级保健和泌尿科诊所进行，纳入年龄≥50 岁的男性患者，这些患者被诊断为（在研究就诊前≤8 年）由 BPH 引起的 LUTS。主要终点是人口统计学和临床特征；次要终点包括在两个医疗保健环境中的疾病进展和诊断测试。
共纳入 670 例患者（初级保健：n=435；泌尿科：n=235）。大多数患者有中重度 LUTS（74.6%）和前列腺体积＞30cc（81.7%），两种环境之间无差异。在初级保健中，前列腺特异性抗原（PSA）≥1.5ng/mL 的患者更多（74.5%），而泌尿科中这一比例为 67.7%。进展标准更为常见（48.9%）。在诊断时，临床标准比国际前列腺症状评分（IPSS）更常用于评估 LUTS（初级保健：临床标准 73.0%；IPSS：26.9%；泌尿科：临床标准 76.5%；IPSS：23.4%）。使用临床标准诊断时，中度/重度 LUTS 的患者比例低于使用 IPSS，使用临床标准时“病情恶化”（从诊断到研究就诊）的患者比例高于使用 IPSS。在两种医疗保健环境中，最常用的诊断测试是一般和泌尿科临床病史和 PSA。
西班牙 BPH 患者的人口统计学和临床特征在初级保健和泌尿科中相似；然而，用于评估 LUTS 严重程度的评估标准存在差异，且不完全符合临床指南建议。增加对推荐评估的使用可能会增强 BPH 的最佳管理。
