Treatment-seeking behaviour and stated preferences for prostatectomy in Spanish men with lower urinary tract symptoms.

Abstract

To determine whether men in the community with lower urinary tract symptoms sought treatment, would choose to have a prostatectomy, and the factors that might influence their decision. The study was a cross-sectional population survey using interviewers in the autonomous community of Madrid and comprised 2002 men aged > or = 50 years. The main outcome measures were self-reported International Prostate Symptom Scores (IPSS), treatment-seeking behaviour and the patients' stated preference for prostatectomy. The response rate among eligible subjects was 68.1%; overall, 38.2% of men sought medical advice for their lower urinary tract symptoms. Whether a man sought medical advice was related to symptom severity, 'bothersomeness', interference in daily activities and his perception of the future; of these, bothersomeness and interference in activities were more likely to determine whether or not a man consulted his doctor. Most men in the sample (84.9%) reported that they would choose a prostatectomy, although this value depended on whether they had had a previous prostatectomy, were younger, and on the content of the information presented. Men were more likely to report that they would accept surgery if their doctor recommended it and less likely when presented with information on the outcomes of treatment. Many Spanish men with lower urinary tract symptoms do not seek medical advice for their symptoms, although most stated that they would accept a prostatectomy on the recommendation of their doctor. Further research should examine whether reported patient preferences correspond to actual behaviour and what is the most appropriate type of information to give to potential patients.