• Bernardino Miñana, MoleroJosé MaríaJMPrimary Care Centre San Andrés, Madrid, Spain., Alfonso Agra Rolán, Miguel Téllez Martínez-Fornes, Rafael Cuervo Pinto, David Lorite Mingot, Ágata Carreño, and Juan Manuel Palacios-Moreno.
• Urology Department, University Clinic of Navarra, Pamplona, Spain.
• Int. J. Clin. Pract. 2021 Aug 1; 75 (8): e14250.

ObjectivesThis study aimed to describe the real-world therapeutic management of patients with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) (LUTS/BPH) attending primary care and urology clinics in Spain.MethodsThis observational, retrospective, multicentre study included men ≥50 years of age diagnosed with LUTS/BPH (≤8 years prior to study visit) (N = 670). Therapeutic management according to healthcare service (primary care vs. urology clinics) or progression criteria, proportion of patients with treatment change, patient profile according to therapy and evolution of LUTS severity were assessed.ResultsOverall differences were noticed in the management of patients between healthcare service (P < .001) and with or without progression criteria (P < .05). Most patients received pharmacological treatment at diagnosis (70.7%; 474/670), which increased at study visit (81.6%; 547/670) with overall similar profiles between primary care and urology clinics for each therapy. α1-Blockers were the most used pharmacological treatment across healthcare settings at diagnosis (61.8%; 293/474) and study visit (51%; 279/547). Only 27.1% (57/210) of patients with progression criteria at diagnosis and 35.6% (99/278) at study visit received 5α-reductase inhibitor (5ARI) alone or in combination with a α1-blocker. Overall, most patients did not change treatment (60%; 402/670) with a trend of more patients worsening in symptoms when not receiving α1-blocker plus 5ARI combination therapy.ConclusionMost patients with LUTS/BPH received pharmacological treatment; however, most men with progression criteria did not receive a 5ARI alone or in combination. These results support the need to reinforce both primary care and urologists existing clinical guideline recommendations for the appropriate medical management of patients with LUTS/BPH.© 2021 The Authors. International Journal of Clinical Practice published by John Wiley & Sons Ltd.

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