Understanding the perception and practice of primary care physicians (PCPs) in the management of lower urinary tract symptoms (LUTS): A multicentric survey

Author : Bhavya Shetty, Aditi Jain, Pankaj Sonone

Abstract : Background: This survey aimed to assess the current perceptions and practices of Indian PCPs about management of LUTS associated with BPH. Methodology: A multicentric survey [27 questions] (Ethics Committee Approval: ECR/91/Indt/MH/2013/RR-29) was conducted among PCPs assessing the diagnosis, treatment and challenges faced during LUTS management. Results: Two-hundred nineteen (219) PCPs participated in the survey conducted from September 2024-May 2025. Majority PCPs (53.9%; n=118) reported nocturia and 37.9%(n=83) slow stream as the most common storage and voiding symptoms. Most PCPs (72%) recommend watchful waiting for patients with non-bothersome mild-moderate symptoms. Most common non-pharmacological management approaches reported by PCPs were lifestyle modifications (34%; n=175) and behavioural therapies (32%; n=164). Most PCPs (65%; n=143) reported patient age as an important factor for selecting alpha-blocker for management, followed by 62% (n=135) reporting symptom severity and 55% (n=121) reporting associated co-morbidities. About 79% (n=173) PCPs prefer alpha blockers in prostate volumes<30cc, and 85% (n=186) recommend alpha-blocker+5 alpha reductase inhibitors (5ARIs) for prostate volumes>30cc. Other preferred treatment options for prostate volume<30cc were reported by 68% (n=149) PCPs as phytotherapy; 61% (n=134) PCPs as Phosphodiesterase-5 inhibitors (PDE5Is), and by 55% (n=121) PCPs as alpha blocker+PDE5Is. Most PCPs (95%; n=209) prefer silodosin±5ARIs for patients with cardiovascular comorbidities, and 56% (n=123) PCPs prefer tadalafil±alpha-blocker for those with erectile dysfunction. Silodosin±5ARIs was favoured across patient subgroups, particularly by 76% (n=167) PCPs for patients aged 50–60 years and by 89% (n=189) PCPs for patients aged >60. While managing BPH patients, 24%(n=158) PCPs report patients' compliance and 17% (n=112) report monitoring treatment effectiveness as common challenges. Conclusion: Overall, Indian PCPs demonstrate structured approach to LUTS management, with reliance on symptom-based diagnosis; however, challenges like patient compliance and monitoring treatment effectiveness persist.

Keywords : LUTS, BPH, patient management, primary care physicians.

Conference Name : National Conference on Medical and Health Sciences (NCMHS-26)

Conference Place : Pune, India

Conference Date : 14th Jun 2026