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Hey All

I just was doing some research and came across this Survey.

It was done in 2002 & 2003 by 502 Patients and 100 Urologist in 5 country's. France, Germany, Italy, Spain and the UK. It is on the Patients and Doctors perception of BPH.

The patients first: Some of there concerns were cancer, lack of sleep, discomfort or embarrassment ( Sexual Functions ) Surgery was also a concern and the side effect from the surgery.

87% of the Urologist believe it will progress and 78% believe that 5 ARI's will stop the prostate from getting worse. However most urologist will give you A Blockers while only a few will give you 5 ARI's I will try to explain more later.

The study highlights the discrepancies between view and beliefs of the patients and the urologist.

Firstly BPH treatments focused on short term relief of the symptoms. Like I say before current care is to prescribe a A blocker which will relax the bladder neck and give you rapid relief. While if they gave you 5 ARI's this will inhibited the conversion of the testosterone to dehydrotestosterone ( DH ) The principal driver that make the prostate grow.

There were 2 questionnaires. One for the patients and one for the doctors. It does not say if they were the same questionnaires. The men were 45 to 80 years of age. 56 % of the men know what BPH was. 69% only talk to there wife's or partners about there BPH problems.

Most of the time men will wait 10 weeks or more to go see a doctor. They were either scared or thought is was there age. 95 % had problems with sleeping because of getting up at night. 19% had there med's changed because they did not like the side effect of the first med's that they were taking. 75% said that they would rather take pills over surgery. It also will depend on what meds you were getting. A blockers or the 5 ARI Therapy.

When assessing patients every country has a different way of on going care. 59% believe that the patient will progress to AUR in 4 years. While 82 % feel that 10 % of the men will need some type of prostate surgery. in the next 4 years.

Now with the urologist there were 20 in each country. 45% of the urologist feel that BPH has to do with aging but we have seen men in there 30's having a problem. They also feel men wait to long to see a doctor this is at 91%. 56% believe when a man finely get to there doctor it is to late and it is time for surgery. 96 % do feel that DRE & PSA test are needed. But in the UK only 35% of doctor only do PSA test.

There is a lot more in this survey that was talk about. It just make me wonder why the treatment very from country to country.

Take care all. Ken

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11 Replies

  • Posted

    Ken, thank you so much for all your help and information on BPH and relate matters. In this particular thread, I don't understand 97% of your acronyms. LOL

    Chuck

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    • Posted

      Hey Chuck

      There was a lot of information on the survey. Half was from the patients and the other was the Urologist. How both view BPH. I had to read it a few times to try to make since of it myself. It was a lot of percents of everything. Either treatments or med's

      I'm sorry that you did not understand it. Have a good day...Ken

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    • Posted

      Haha agree acronyms are confusing

      5-alpha-reductase inhibitor (5-ARI)

      AUR is Acute urinary retention (AUR)

      DRE- digital rectal exam ?

      PSA- prostate specific antigen

      But i do have a question for the group- has anyone tried this new IsoPSA test- my Urologist wanted me to get it done - but cost was $1000 and i already know i have BPH and not cancer after 5 biopsies and an MRI (I did let him talk me into a urodynamics test which confirmed that prostate was blocking uretha and not an overactive bladder- looking back this was a waste for me- since switched urologists)

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  • Posted

    Ken,

    So, back in 2014 I had total retention after radiation to the prostate and this lasted for 5 weeks. I had 6 Foleys put in, taken out, in, out, etc. until I could finally pee. During this time my uro told me I should learn to CIC. Not bad advice. So, his nurse gave me one and a tube of lube and put me in an exam room all alone. I tried to get the cath in for about a half hour - it hurt and I was scared. Never was able to complete the task. Thought I would never, ever try that again. So, I then asked my uro if he had ever tried to self cath and he said no. Great, he doesn't have any idea what this is like.

    Subsequently, I sent for some catheter samples from various companies and was finally able to complete the task using a 14fr hydrophilic catheter - very slippery and smooth. I did this a few times in difficult situations - better than rushing to the ER as I did the first time I was in total retention. I still have some catheters on hand and may try to use them again since my retention is progressing. At least now I have the right ones and know how to use them if I have to.

    Tom

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    • Posted

      Hey Tom

      That is true. I would say that at least 10 % of doctor don't know how a catheter feels to be put in. Maybe that should be part of there training. That is the same on some of the meds that they are giving out. They do not know the side effect of it.

      I forget to mention. That most of the patients were scared to have surgery because of the sexual problems that they caused. The urologist did not think that was a problem to talk about. All they are worried about is to get you to be better. Nothing else matters.

      Have a good day Tom.............Ken

      PS. I shut down a year ago because my bladder was inflamed. My doctor told me it was a good Idea to learn to do CIC. I said okay. He said him or a nurse would help me. I said no. I will learn on my own. It took me 3 days and 5 try but I got it.

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    • Posted

      Asking a doctor a question about his own medical condition or if he ever self catheterized himself will of course get you a negative answer. Doctors consider it unprofessional to discuss their own medical problems with their patients. Doctors will rarely comment on this site although some might without identifying themselves as such. Sometimes you can tell by some of the medical terms they use.

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    • Posted

      Lester

      That is true most doctor will not volunteer information about there self. I think it is how you ask them. You can ask them what would you do and if they did do it they are not going to lie about it.

      But it also has to do what kind of relationship you have with your doctor. My heart doctor I have had for 15 years. He tell me a few things. When I first met him. He was 460 pounds. He is 6'6". I was 340 at that time.

      Over the years we have had diet talks and other things.. His barbecue ribs are great. I think I bet him. He did lose a 100 pounds and I am down to 180.

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  • Posted

    Given that survey is over 15 years old I suspect the results would be a little different but the discrepancy between patient and Doctor would still be very similar. The role of the internet has meant patients are much more likely to be more aware of options. Doctors on the other hand, particularly Urologists, still, I stress in my experience and from what I read here, have an appalling lack of a grasp on what BPH is like for men. Why? Because they overwhelmingly don't suffer from it because they are usually too young. I like the idea that part of their training includes compulsory catheterisation.

    If we were women the howl of outrage at the way in which their health was being ignored, ascribed second class medical citizenship, would be seldom off the airwaves. I have to say in that regard we are culpable. The one part of that survey, if conducted today, that wouldn't have changed significantly is men willing to consult a Doctor early and talk about the problem amongst themselves. A forum like this is largely successful in over coming that because it is relatively anonymous. We need to make more fuss. As part of an ageing population sadly our numbers grow, but in that we have an opportunity to have our multitudinous voices heard. If every consultation with a Urologist was accompanied by a mini rant about the lack of sympathy to the side effects of "treatment" or acknowledgement of the paucity of options that specifically address the individual symptoms, based on a proper assessment of that individual and not something that has to be fought for, rather than a fairly dismissive one-size fits all approach. We might just start to make some progress towards driving some genuinely effective research into not just effective clinical interventions but a more sympathetic and accurate assessment of what exactly is the individual patients problem.

    It might even result in Urologists training being changed to treat the individual and not just their symptoms. That their need to urinate properly does not trump everything else.

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    • Posted

      Good Morning

      Yes I know it's 15 years old. But that is the one that I came across. I will be looking for a newer one

      And If they did it today it would most likely be some what different because we have a few treatments that were not around 15 years ago. Urologist do have a different view on there patients. Most do look at the whole patient and the patients concerns.

      I think we have better training now but that is only if they want to learn to give there patients the best care they can. Also today I think men are learning to take charge of there body's and not give up.

      Take care Ken

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    • Posted

      Part 2

      Sorry I forgot something.

      Yes men are taking better care of themselves and going much more to the doctor with there problems down below. Years ago it was not talk about much. It was nothing you talk about with your buddy's over a beer.

      But there are still a few that do wait till the last minute because off some of test that have to be done ( DRE ) They should not worry about it. It does not take long and the doctor thinks nothing about it.

      Thank god for site like this so we can talk more open about our BPH problems. Who is going to know what we are going through but another man.

      Good Health to All............................Ken

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  • Posted

    Good morning All

    I just want to say I'm sorry for the last post. I did not mean it to be confusing. I think it was just to much information and it was not written in the right way.

    My main concern was to give you information for you all to make the right decision for you. It is hard enough when you start to have BPH problems.

    Finding the right doctor is a key to any procedure. They do know a lot but all doctors treat the same problem in different ways. It is there opinion That is when it get hard. What do you pick. Also make sure they address all of your questions and concerns. If they give you 10 minutes and move on . It's time to move on to another doctor

    The main thing here is you have to be 100% sure of the procedure you pick for yourself. Healing time, side effects should be a concern.

    In closing again doctor's are very well trained but you have the final say of what you are going to have done to your body. Do not let a doctor force you into anything you do not want.

    Take care all and good health............Ken

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