Literature DB >> 18781209

The Canadian Benign Prostatic Hyperplasia Audit Study (CanBas).

J Curtis Nickel1, Joe Downey, Francois Bénard, Michael Chetner, John Grantmyre, Alan So, Paul Whelan.   

Abstract

OBJECTIVE: To determine the prevalence, diagnostic patterns and management of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) in Canadian urology outpatient practice.
METHODS: Representative urologists were randomly selected from lists provided by the Canadian and Quebec Urological Associations. Each patient identified with a BPH diagnosis during a typical 2-consecutive-week period during April, May or June 2007 was asked to complete a corresponding International Prostate Symptom Score (IPSS) questionnaire. Each day, the participant urologist completed an outpatient log and a detailed programmed chart review to transcribe demographics, investigations and treatments associated with each BPH patient.
RESULTS: Eighty-six urologists were invited to participate. Thirty-eight (44.2%) agreed, and 27 of those (71.1%) submitted evaluable data for the audit. Of the 5616 patients seen in outpatient practice (average 208 per urologist), 4324 (77%) were male. A BPH diagnosis was identified in 19.6% of the men (n = 849; mean age 69.5, standard deviation [SD] 10, yr; age range 40-100 yr; mean duration of symptoms 4.8, SD 4.2, yr; mean IPSS score 12.3, SD 7.4; mean prostate specific antigen [PSA] 3.9, SD 3.9, ng/mL). Twenty-four percent of patients had prostates that were rated as large, 50% as medium and 26% as small. PSA level correlated positively with prostate volume. Twenty-two percent were initial consultations for LUTS and 78% were repeat visits. Diagnostic evaluation tended to follow those examinations and tests recommended by the Canadian BPH guidelines. Treatment choices tended to follow an evidence-based algorithm with respect to treatment choices for men in the various prostate-volume and PSA groups.
CONCLUSION: This prospective audit indicates that BPH remains a common condition managed by urologists in outpatient practice. Investigations and treatments confirm that Canadian urologists appear to be following Canadian BPH guidelines as well as the most recent evidence from the literature.

Entities:  

Year:  2008        PMID: 18781209      PMCID: PMC2532544          DOI: 10.5489/cuaj.629

Source DB:  PubMed          Journal:  Can Urol Assoc J        ISSN: 1911-6470            Impact factor:   1.862


  12 in total

1.  The American Urological Association 2003 guideline on management of benign prostatic hyperplasia: a Canadian opinion.

Authors:  J Curtis Nickel; Fred Saad
Journal:  Can J Urol       Date:  2004-04       Impact factor: 1.344

2.  Practice patterns of Canadian urologists in benign prostatic hyperplasia and prostate cancer. Canadian Prostate Health Council.

Authors:  E W Ramsey; M Elhilali; S L Goldenberg; C J Nickel; R Norman; J P Perreault; B Piercy; J Trachtenberg
Journal:  J Urol       Date:  2000-02       Impact factor: 7.450

3.  Canadian guidelines for the management of benign prostatic hyperplasia.

Authors:  J Curtis Nickel; Sender Herschorn; Jacques Corcos; Bryan Donnelly; Doug Drover; Mostafa Elhilali; Larry Goldenberg; John Grantmyre; Bruno Laroche; Richard Norman; Bruce Piercy; Karen Psooy; Gary Steinhoff; John Trachtenberg; Fred Saad; Simon Tanguay
Journal:  Can J Urol       Date:  2005-06       Impact factor: 1.344

4.  Serum prostate-specific antigen concentration is a powerful predictor of acute urinary retention and need for surgery in men with clinical benign prostatic hyperplasia. PLESS Study Group.

Authors:  C G Roehrborn; J D McConnell; M Lieber; S Kaplan; J Geller; G H Malek; R Castellanos; S Coffield; B Saltzman; M Resnick; T J Cook; J Waldstreicher
Journal:  Urology       Date:  1999-03       Impact factor: 2.649

Review 5.  Definition of at-risk patients: baseline variables.

Authors:  Claus G Roehrborn
Journal:  BJU Int       Date:  2006-04       Impact factor: 5.588

6.  The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride Long-Term Efficacy and Safety Study Group.

Authors:  J D McConnell; R Bruskewitz; P Walsh; G Andriole; M Lieber; H L Holtgrewe; P Albertsen; C G Roehrborn; J C Nickel; D Z Wang; A M Taylor; J Waldstreicher
Journal:  N Engl J Med       Date:  1998-02-26       Impact factor: 91.245

7.  Alpha-blocker therapy can be withdrawn in the majority of men following initial combination therapy with the dual 5alpha-reductase inhibitor dutasteride.

Authors:  J Barkin; M Guimarães; G Jacobi; D Pushkar; S Taylor; O B van Vierssen Trip
Journal:  Eur Urol       Date:  2003-10       Impact factor: 20.096

8.  Serum prostate-specific antigen and prostate volume predict long-term changes in symptoms and flow rate: results of a four-year, randomized trial comparing finasteride versus placebo. PLESS Study Group.

Authors:  C G Roehrborn; P Boyle; D Bergner; T Gray; M Gittelman; T Shown; A Melman; R B Bracken; R deVere White; A Taylor; D Wang; J Waldstreicher
Journal:  Urology       Date:  1999-10       Impact factor: 2.649

9.  The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia.

Authors:  John D McConnell; Claus G Roehrborn; Oliver M Bautista; Gerald L Andriole; Christopher M Dixon; John W Kusek; Herbert Lepor; Kevin T McVary; Leroy M Nyberg; Harry S Clarke; E David Crawford; Ananias Diokno; John P Foley; Harris E Foster; Stephen C Jacobs; Steven A Kaplan; Karl J Kreder; Michael M Lieber; M Scott Lucia; Gary J Miller; Mani Menon; Douglas F Milam; Joe W Ramsdell; Noah S Schenkman; Kevin M Slawin; Joseph A Smith
Journal:  N Engl J Med       Date:  2003-12-18       Impact factor: 91.245

10.  The effects of dutasteride, tamsulosin and combination therapy on lower urinary tract symptoms in men with benign prostatic hyperplasia and prostatic enlargement: 2-year results from the CombAT study.

Authors:  Claus G Roehrborn; Paul Siami; Jack Barkin; Ronaldo Damião; Kim Major-Walker; Betsy Morrill; Francesco Montorsi
Journal:  J Urol       Date:  2007-12-21       Impact factor: 7.450

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  3 in total

1.  Cost analysis of fixed-dose combination of dutasteride and tamsulosin compared with concomitant dutasteride and tamsulosin monotherapy in patients with benign prostatic hyperplasia in Canada.

Authors:  Amyn Sayani; Afisi Ismaila; Anna Walker; John Posnett; Bruno Laroche; J Curtis Nickel; Zhen Su
Journal:  Can Urol Assoc J       Date:  2014 Jan-Feb       Impact factor: 1.862

2.  Changes in initial expenditures for benign prostatic hyperplasia evaluation in the Medicare population: a comparison to overall Medicare inflation.

Authors:  Adam S Bellinger; Sean P Elliott; Liu Yang; John T Wei; Christopher S Saigal; Alexandria Smith; Timothy J Wilt; Seth A Strope
Journal:  J Urol       Date:  2012-03-15       Impact factor: 7.450

3.  Prostatic Artery Embolization for Benign Prostatic Hyperplasia: A Health Technology Assessment.

Authors: 
Journal:  Ont Health Technol Assess Ser       Date:  2021-06-04
  3 in total

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