MONDAY, Nov. 9 (HealthDay News) -- The evaluation and treatment of benign prostatic hyperplasia (BPH) by primary care physicians (PCPs) is less rigorous than evaluation and treatment by urologists, according to a study in the November issue of The Journal of Urology.

John M. Hollingsworth, M.D., of the University of Michigan in Ann Arbor, and colleagues reviewed medical claims from a managed care organization from 1997 to 2005 on 1,055 members with BPH who received initial treatment either from a PCP or a urologist. Logistic regression was used to assess the differences in BPH evaluation and the therapeutic approach between PCPs and urologists.

While no significant difference was seen in the use of prostate specific antigen testing between PCPs and urologists, the researchers found that office-based procedures (cystourethroscopy and prostate needle biopsy) and urodynamic tests were used exclusively by urologists. The specialists performed urinalysis tests and transrectal ultrasonography more frequently than PCPs and were twice as likely to order a laboratory study. Urologists were also more likely to prescribe a BPH medication. In addition, urologists prescribed selective α-adrenergic blockers, 5α-reductase inhibitors and combination therapy more than PCPs.

"On average, urologists had a higher intensity practice style for BPH than PCPs. Further studies are needed to determine how these practice style differences relate to patient clinical outcomes," the authors conclude.

One study author reported financial relationships with several pharmaceutical companies.

Abstract
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