Prosyannikov M.Y.
Scientific Research Institute of Urology named after N.A. Lopatkin, Branch of the Hertsen Federal Medical Research Centre of the Ministry of Health of the Russian Federation

Contacts: Mikhail Prosyannikov, email: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Abstract. Background. Benign prostatic hyperplasia is a gender specific, socially important disease, as it accounts for more than 40% of all diseases in men over 50 years.

The study found out that 40.9% of patients with benign prostatic hyperplasia who were treated in hospitals were brought in by ambulance for emergency care. This statement is based on the analysis of benign prostatic hyperplasia diagnosis and treatment in the Russian Federation exemplified by one of its regions – the Voronezh region, in 2009. Such urgent hospitalization implies insufficient prevention and disease detection.

To improve quality of health care delivery to patients with benign prostatic hyperplasia a comprehensive program on standardized step-wise delivery of urological care was developed and introduced into Voronezh region in 2011.

Methods and data. There are three steps in urological care delivery. The first step is timely detection of patients. The second step is performance of standard therapeutic manipulations including surgery. Seven interdistrict urological centers were opened to provide this type of care. As a third step, a regional urological center was set up under the regional clinical hospital #1.

Results: As a result of the program activities the number of registered patients with benign prostatic hyperplasia increased by 311.15%. The share of patients with complicated forms of benign prostatic hyperplasia significantly reduced resulting in a 6.3-fold decrease in emergency hospitalization of patients with benign prostatic hyperplasia. Also, standardization of all steps of care delivery to patients with benign prostatic hyperplasia allowed to reduce complications of surgical treatment of benign prostatic hyperplasia by 2.4 times.

Conclusions: the comprehensive program of standardized step-wise urological care delivery «Urology» is a universal tool for improving care organization in case of benign prostatic hyperplasia.

Keywords: benign prostatic hyperplasia; urology service of the Voronezh region; "Urology" program; comprehensive program of standardized step-wise care delivery.

References:

1. Vinarov A.Z., Aslamazov E.G. Giperplaziya predstatel'noy zhelezy, sovremennoe lechenie [Prostatic hyperplasia, modern treatment]. Materialy 10-go Rossiyskogo s"ezda urologov. Moscow 2002. P. 33-42. (In Russia).
2. Vorob'ev PA, Avksent'eva MV, Yur'ev AS, Sura MV. Kliniko-ekonomicheskiy analiz (otsenka, vybor meditsinskikh tekhnologiy i upravlenie kachestvom meditsinskoy pomoshchi) [Clinical and economic analysis (assessment, selection of medical technologies, and quality management of health care)]. Moscow: N'yudiamed; 2004. 404 p. (In Russia).
3. Tkachuk V.N., Luk'yanov A.E. Dobrokachestvennaya giperplaziya predstatel'noy zhelezy [Benign prostatic hyperplasia]. St. Petrsburg: SpetsLit; 2003. 109 p. (In Russia).
4. Shchepin OP, Tishuk EI. Problemy demograficheskogo razvitiya Rossii [Problems of demographic development of Russia]. Ekonomika zdravookhraneniya 2005; (3):5-8. (In Russia).
5. Smolyakova TN. Pensionery pokroyut defitsit rabochey sily [Pensioners will compensate the labor shortage]. Rossiyskaya gazeta [Online] 16.12.2013. (cited 2014 Sep 18). Available from: http://www.rg.ru/2013/12/16/zanatost-site.html. (In Russia).
6. Altwein JE, Jacobi GH. Urologie Enke Verlag. Stuttgart, 1986. 136 p.
7. Bruskewitz R. Management of symptomatic BPH in the US: who is treated and how? Eur Urol 1999; (36): 7-13.
8. Drach G, Layton T, Binard W. Male peak urinary flow rate: relationships to volume voided and age. J Urol 1979;(122):210-214.
9. Farmer R, Clifford JG. Incidence and prevalence of LUTS/BPH in the UK in the 1990. BJU Int 2002: (90): 74.
10. Garraway WM., Collins GN., Lee RJ. High prevalence of benign prostatic hypertrophy in the community. Lancet 1991; (338): 469-471.
11. Kaplan SA, Olsson CA, Te AE. The American Urological Association symptom score in the evaluation of men with lower urinary tract symptoms: at 2 years of follow up, does it work? J. Urol 1996; (155): 1971-1974.
12. Kok ET, Schouten BW, Bohnen AM, Groeneveld FP, Thomas S, Bosch JL. Risk factors for lower urinary tract symptoms suggestive of benign prostatic hyperplasia in a community based population of healthy aging men: the Krimpen Study. J Urol 2009; (181): 710-716
13. Loh SY, Chin CM. A demographic profile of patients undergoing transurethral resection of the prostate for benign prostate hyperplasia and presenting in acute urinary retention. BJU 2002; (89): 531-533.
14. Oishi K, Boyle P, Barry MJ. Epidemiology and natural history of benign prostatic hyperplasia. Proceedings of 4th International Consultation on benign prostatic hyperplasia, Paris, 1997.
15. Rosen R, Altwein J, Boyle P, Kirby RS, Lukacs B, Meuleman E, et. al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol 2003; (44): 637-649
16. Schulman CC. The aging male: a challenge for urologists. Curr Opin Urol 2000; (10):337-342
17. Temml C, Brössner C, Schatzl G, Ponholzer A, Knoepp L, Madersbacher S. Prostate Study Group of the Austrian Society of Urology. The natural history of lower urinary tract symptoms over five years. Eur Urol 2003;(43): 374-380

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