Factors influencing practices for chronic prostatitis: a nationwide survey of urologists in South Korea

Abstract

BACKGROUND: We investigated the influence of physicians' attitudes on the treatment of chronic prostatitis, and attempted to correlate demographic and professional characteristics with patterns of therapy regarding chronic prostatitis. METHODS: Probability samples were drawn from the Korean Urological Association Registry of Physicians, and a random sample of 850 Korean urologists were asked to complete a questionnaire which explored practice characteristics, attitudes, and diagnostic and treatment strategies for the management of chronic prostatitis. The returned questionnaires were statistically analysed. RESULTS: Of the 850 questionnaires sent, 302 were returned, and 275 of those were included in the final analysis (response rate 32.4%). Multivariate logistic regression analysis indicated that the type of hospital (P < 0.001) and belief that culture tests helped diagnose chronic prostatitis (P = 0.001) were the most determinant factors with respect to the routine performance or non-performance of culture tests. Most Korean urologists (96.4%) prescribed antibiotics for the primary treatment of chronic prostatitis. Even when primary antibiotic treatment was unsuccessful, urologists frequently prescribed a second course of antibiotics (57.8%). In the multivariate model used, the likelihood of prescribing antibiotics as a secondary treatment varied by the type of hospital, with 0.4-fold odds (odds ratio [OR], 0.43; 95% confidence interval [CI], 0.21-0.87; P = 0.019) of the practice occurring in university hospitals, as opposed to primary clinics. According to the same model, the belief that culture tests help to diagnose chronic prostatitis was also an independent influencing factor (OR, 2.29; 95% CI, 1.39-3.77; P = 0.001), whereas the actual performance of culture tests had no statistical significance. CONCLUSION: Our findings suggest that the personal beliefs and professional characteristics of physicians may influence the diagnosis and treatment of chronic prostatitis in Korea.