Yonsei Med J.  2010 May;51(3):432-437. 10.3349/ymj.2010.51.3.432.

The Urologist's View of Male Overactive Bladder: Discrepancy between Reality and Belief in Practical Setting

• Lee SH
• Kim JC
• Lee KS
• Lee JG
• Park CH
• Hong SJ
• Kim CS
• Park JK
• Chung BH

• KMID: 1074997
• DOI: http://doi.org/10.3349/ymj.2010.51.3.432

Abstract

PURPOSE
In order to gain insight into the physicians' awareness of and attitude towards management of overactive bladder (OAB) in males, we performed a nationwide survey of the current strategies that urologists use to diagnose and manage OAB in male patients.
MATERIALS AND METHODS
A probability sample was taken from the Korean Urological Association Registry of Physicians, and a random sample of 289 Korean urologists were mailed a structured questionnaire that explored how they manage benign prostatic hyperplasia (BPH).
RESULTS
A total of 185 completed questionnaires were returned. The consent rate in the survey was 64.5%. Eighty-one (44%) urologists believed that of all males with lower urinary tract symptoms (LUTS), 20% or more had OAB and 72 (39%) believed that 10-20% had OAB. Half of the urologists surveyed believed that the most bothersome symptom in male OAB patients was nocturia. Seventy-three percent of respondents reported that they prescribed alpha blockers with anticholinergics for first line management, while 19% of urologists prescribed alpha blocker monotherapy but not anticholinergics for OAB patients. Though acute urinary retention (AUR) was considered the anticholinergic adverse event of most concern, the most frequently observed adverse event was dry mouth (95%).
CONCLUSION
The present study provides insights into urologist views of male OAB. There is a discrepancy between the awareness of urologists and actual patterns of diagnosis and treatment of male OAB. This finding indicates the need to develop further practical guidelines based on solid clinical data.

Keyword

Overactive bladder; physician's practice patterns; bladder outlet obstruction; benign prostatic hyperplasia; anticholinergics

MeSH Terms

Adrenergic alpha-Antagonists/therapeutic use
Cholinergic Antagonists/therapeutic use
*Health Knowledge, Attitudes, Practice
Humans
Male
Physician's Practice Patterns
Physicians/*psychology
Prostatic Hyperplasia/diagnosis/drug therapy/pathology
Questionnaires
Urinary Bladder Neck Obstruction/diagnosis/drug therapy/pathology
Urinary Bladder, Overactive/*diagnosis/drug therapy/pathology
Urinary Retention/diagnosis/drug therapy/pathology
*Urology

Figure

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  Fig. 1 Urologist perceptions of the most bothersome symptoms of male OAB. OAB, overactive bladder.

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  Fig. 2 Treatment alternatives for male OAB patients who do not respond to medication. OAB, overactive bladder.

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