Quick Prostate Test (QPT): motion for a tool for the active contribution of the general pratictioner to the diagnosis and follow up of benign prostatic hyperplasia.

INTRODUCTION: Less than 40% of men with LUTS consult their doctor. Patients consider the LUTS as physiological and are resigned to endure them. It is necessary to foster awareness of the micturition disorders, to monitor their development and to assess the effectiveness of therapies. At present the only validated test is the IPSS-Q8, but in Italy it is used by only 4% of General Practitioners (GPs). Because the IPSS is complex and not easy to handle, we need a more simple test but nevertheless efficient. The Italian Society of Urology (SIU) and the Italian Society for Interdisciplinary Primary Care (SIICP) presented the "Quick Prostate Test" (QPT) in November 2012. We aimed to evaluate the efficiency of QPT versus the IPSSQ8 and its suitability in primary care. MATERIALS AND METHODS: The QPT is composed of 3 questions to be answered "yes" or "no." The answer "yes" just to one question makes "positive" the test. We enrolled 64 men, ≥ 50 years old, suffering from BPH, extracted from the database of five GPs. The patients were randomized into two arms: to the arm 1 only QPT was administered, to verify efficiency of the test; to the arm 2 both the QPT that the IPSS-Q8 were administered. RESULTS: Into the arm 1, the 96.4% has tested positive for QPT. Into the arm 2, the 89% of patients with one or two positive responses to the QPT showed a moderate IPSSQ8 score; the 75% of the patients with three positive responses to the QPT had a serious IPSS-Q8 score. The GPs (80%) have expressed the highest level of satisfaction for the QPT for the "time of administration" and for the "simplicity" of the test. CONCLUSIONS: The experience with the QPT has shown that the test is efficient and suitable in the primary care setting. We want to encourage the GPs to use the QPT for the monitoring of patients with lower urinary tract symptoms (LUTS) and to contribute to the validation of the test.

Evidence-based guidelines for the treatment of lower urinary tract symptoms related to uncomplicated benign prostatic hyperplasia in Italy: updated summary from AURO.it.

BACKGROUND: The first Italian national guidelines were developed by the Italian Association of Urologists and published in 2007. Since then, a number of new drugs or classes of drugs have emerged for the treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH), new data have emerged on medical therapy (monotherapies and combination therapies), new surgical techniques have come into practice, and our understanding of disease pathogenesis has increased. Consequently, a new update of the guidelines has become necessary. METHODS: A structured literature review was conducted to identify relevant papers published between 1 August 2006 and 12 December 2010. Publications before or after this timeframe were considered only if they were recognised as important milestones in the field or if the literature search did not identify publications within this timeframe. The quality of evidence and strength of recommendations were determined according to the Grading of Recommendations Assessment, Development and Evaluation framework. MAIN FINDINGS: Decisions on therapeutic intervention should be based on the impact of symptoms on quality of life (QoL) rather than the severity of symptoms (International Prostate Symptom Score (IPSS) score). A threshold for intervention was therefore based on the IPSS Q8, with intervention recommended for patients with a score of at least 4. Several differences in clinical recommendations have emerged. For example, combination therapy with a 5α-reductase inhibitor plus α blocker is now the recommended option for the treatment of patients at risk of BPH progression. Other differences include the warning of potential worsening of cognitive disturbances with use of anticholinergics in older patients, the distinction between Serenoa repens preparations (according to the method of extraction), and the clearly defined threshold of prostate size for performing open surgery (>80 g). While the recommendations included in these guidelines are evidence based, clinical decisions should also be informed by patients' clinical and physical circumstances, as well as patients' preferences and actions. CONCLUSIONS: These guidelines are intended to assist physicians and patients in the decision-making process regarding the management of LUTS/BPH, and support the process of continuous improvement of the quality of care and services to patients.