A European survey of men's health services has found a significant shortage of urologists or prostate disease specialists in the Republic. The study of eight European countries, which was funded by the EU and the Department of Health and Children, examined the impact of prostate disease on men's quality of life.
It found that there was a lack of awareness of how the symptoms of benign prostate disease affected issues such as men's work and their sexuality. The lack of awareness affected both doctors and patients alike.
Project leader and expert in men's health, Prof Tom O'Dowd, professor of community health and general practice at Trinity College Dublin, said: "The problem is exacerbated in the Republic by a gross shortage of urologists so that even if men were more informed the urology services would be swamped."
The report found there were only 23 urologists in the State, representing a rate of 3.2 specialists per 100,000 males aged 40 years and over. Spain topped the table with a ratio of 19.0; Slovenia, formally part of the Yugoslav Federation, has 7.2 specialist urologists per 100,000 males over 40.
Benign prostatic hyperlasia (BPH) affects one in three men over the age of 50. It causes symptoms in 80 per cent of men over 70, such as frequency in going to the toilet, a weak urinary stream and the need to pass water at night. The enlarged prostate gland narrows the outflow of urine from the bladder giving rise to symptoms. BPH is a separate disease from prostate cancer.
Pointing out that one in five men of working age reported a worsening in their work situation due to the symptoms of BPH, Prof O'Dowd said: "There is a grey area before symptoms are brought to the attention of doctors in which men are floundering due to a lack of information."
While the survey found a large amount of research on the pharmacological aspect of BPH, it uncovered little international research on the impact of the disease and its treatment on patients. It also noted that there was no formal training system for GPs or nurses for non-malignant disease of the prostate.
The impact of BPH on employment was considerable, according to the report . In Denmark, an estimated 13,000 work days were lost per annum due to benign prostate disease, while it accounted for 0.45 per cent of all early retirements from work in the Republic.
Emphasising the need to raise awareness across Europe, Prof O'Dowd called for men to form an alliance with the women's health movement and to learn from its success.
"We have a largely male Cabinet and a largely male medical profession, both of which must come out more strongly and actively argue for improved services," he suggested.
It is estimated that up to 100,000 men in the State may need surgical treatment for BPH should they live to the age of 80. However, without additional urologists, it may not be possible to provide this service. Latest figures show that 1,834 trans-urethral resections of the prostate are carried out here every year at an approximate cost of €1.6 million.
The cost of providing primary care to patients here with BPH is estimated at €8 million.