Influence of Life Circumstances and Personality on BPH Patients’ Treatment Choice

Influence of Life Circumstances and Personality on BPH Patients’ Treatment Choice

Symptomatic Benign Prostate Hyperplasia (BPH) treatment is influenced less by the patient’s personality and more by his life circumstances, according to the results of a study entitled “Influence of Demography and Personality on Patient Choice of Treatment in Symptomatic Benign Prostate Hyperplasia,” recently published in the Israel Medical Association Journal.

Although benign prostate hyperplasia (BPH) is an age dependent condition, it may affect patients’ quality of life due to the decline in self-esteem and sexual health. Poor patient-physician communication and collaboration may likely lead to patients not always choosing the optimal treatment for their specific condition. Although the etiology of BPH is not well clarified, both the medical and surgical treatments comprise various modalities. Moreover, these modalities are often changed during treatment course, causing confusion for both patients and medical staff. Consensus regarding BPH treatment depends on the progression of the disease: the less progressive the disease the more conservative the treatment.

To examine whether patients’ demographics and personality affect their decision regarding the type of treatment, namely conservative or surgical, David Kesari MD, from the Department of Urology, Barzilai Medical Center, in Beer Sheva, Israel and his colleagues conducted a retrospective analysis of 105 BPH patients treated from 2005 to 2008.

Based on the treatment received, researchers categorized all patients into three groups: 56 patients for medication only (group 1), 32 for combined treatment (group 2) and 17 for surgery only (group 3). Patients were considered eligible for the analysis if they had used BPH medication for at least half a year before the study (groups 1 and 2). Group 1 and group 2 completed the International Prostate Symptom Score (IPPS) questionnaire before beginning the treatment and after at least half a year of medication treatment. The third group, approximate age 73 years, presented with urinary retention and were not eligible for IPSS analysis.

All three groups provided demographic data (age, country of origin, education) and completed tri-dimensional personality questionnaires (TPQ) to measure three independent “temperament” personality dimensions and evaluate how different individuals feel or behave: novel seeking (NS), harm avoidance (HA), and reward dependence (RD).

The results showed that the choice of BPH treatment differed according to demographic variables and the RD dimension, leading researchers to conclude that medical advice and patient’s personality have less impact on type of treatment in cases of BPH than in prostate cancer. “In our study, BPH patients’ preference of type of treatment was influenced by their country of origin, age and education. We suggest that although quality of life is influenced by personality traits, patients with benign disease should be more involved with the medical decision,” the researchers concluded.

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