Prescription pattern of alpha blockers in the treatment of benign prostatic hyperplasia in India: a paper based survey

Vinay Tomar, Bhoopat Singh Bhati, Biswajit Datta, Laxman Bellamkonda, Hiren K. Prajapati, Alok Chaturvedi, Nilanj Dave, Amit B. Jain


Background: Benign prostatic hyperplasia (BPH) is the most common urological condition. The treatment of BPH depends on the severity of symptoms which aims to improve symptoms, lower the risk of progression and improve quality of life. The aim of this survey was to understand the prescription pattern of alpha blockers in the treatment of BPH among clinicians of India.

Methods: A cross-sectional questionnaire-based survey was conducted between September to December 2018. Data regarding the management of BPH using α-blockers were filled by clinicians and collated for data analysis using appropriate statistical test.

Results: Total of 1764 clinicians’ responses was collected and the result was analysed. According to the survey, 47.68% of clinicians felt that severity of the BPH symptoms is most common deciding factor for medical management of BPH. For the pharmacological management of BPH patients, around 58% of clinicians opted for α blockers monotherapy as a preferred option. Among α blockers, 65.14% of clinicians preferred tamsulosin as first line therapy for management of BPH patients. In this survey, 81.75% of clinicians believed that tamsulosin offers highest persistence rate among commonly prescribed α blockers. Looking at the switching to a second α-blocker, 75.45% of clinicians felt that tamsulosin shows the highest return rate following initiation of a second α-blocker. More than 90% of clinicians felt that favourable efficacy or tolerability of tamsulosin is due to its highest persistence and highest return rates.

Conclusions: Tamsulosin is the most commonly preferred and prescribed α-blocker by Indian clinicians due to its favourable efficacy or tolerability.


Benign prostatic hyperplasia, Lower urinary tract symptoms, α-blocker, Tamsulosin, Persistence rate, Return rate

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Chute CG, Panser LA, Girman CJ, Oesterling JE, Guess HA, Jacobsen SJ, et al. The prevalence of prostatism: a population-based survey of urinary symptoms. J Urol. 1993;150:85-9.

Konwar R, Chattopadhyay N, Bid HK. Genetic polymorphism and pathogenesis of benign prostatic hyperplasia. BJI Int. 2008;102:536-44.

Woo HH, Gillman MP, Gardiner R, Marshall V, Lynch WJ. A practical approach to the management of lower urinary tract symptoms among men. Med J Aust. 2011;195:34-9.

McConnell JD, Barry MJ, Bruskewitz RC. Benign prostatic hyperplasia: diagnosis and treatment. Agency for Health Care Policy and Research. Clin Pract Guidel Quick Ref Guide Clin. 1994;8:1-17.

American Urological Association. American Urological Association guideline: management of benign prostatic hyperplasia (BPH). Linthicum (MD): American Urological Association Education and Research, Inc.; 2010. Available at: (2010-reviewed-and-validity-confirmed-2014). Accessed on 25 July 2019.

Chughtai B, Forde JC, Thomas DM, Laor L, Hossack T, Woo HH et al. Benign prostatic hyperplasia. Nature Reviews Disease Primers. 2016;2:16031.

Lepor H. Alpha Blockers for the Treatment of Benign Prostatic Hyperplasia. Rev Urol. 2007;9(4):181-90.

WHO Global Health Observatory (GHO) data. Available at: _burden_disease/life_tables/situation_trends_text/en/ Accessed 25 July 2019.

Emberton M, Zinner N, Michel MC, Gittelman M, Chung MK, Madersbacher S. Managing the progression of lower urinary tract symptoms/benign prostatic hyperplasia: therapeutic options for the man at risk. BJU Int. 2007;100:249-53.

Emberton M, Marberger M, de la Rosette J. Understanding patient and physician perceptions of benign prostatic hyperplasia in Europe: The Prostate Research on Behaviour and Education (PROBE) Survey. Int J Clin Pract. 2008;62(1):18-26.

Sabnis RB, Rajeev TP, Sinha S, Srivastava Aneesh, Mittal R. Survey by urological society of India (USI) to understand practice patterns in diagnosis and medical management of voiding LUTS secondary to benign prostatic obstruction (BPO). Int J Sci Res. 2019;8(5):18-21.

Tomašković I, Tomić M, Nikles S, Neretljak I, Miličić V. Croatian urologists’clinical practice and compliance with guidelines in the management of non-neurogenic male lower urinary tract symptoms. Acta Clin Croatica. 2015;54(4):453-7.

Wu N, Sun J, Yu P, Sun Z. Chinese Urologists' Views of Practice Patterns in the Diagnosis and Treatment of Benign Prostatic Hyperplasia: A Nationwide Survey. Int Neurourol J. 2012;16(4):191-5.

Oh CY, Lee SH, Yoo SJ, Chung BH. Korean urologist's view of practice patterns in diagnosis and management of benign prostatic hyperplasia: a nationwide survey. Yonsei Med J. 2010;51(2):248-52.

Moon HW, Yang JH, Choi JB, Bae WJ, Cho HJ, Hong SH, et al. Prescription pattern of alpha blockers for management of lower urinary tract symptoms/benign prostatic hyperplasia. Sci Rep. 2018;8:13223.