Benign Prostatic Hyperplasia (BPH) is common among males in the Veterans Administration (VA) population. The quality of life of such patients can decline significantly since symptoms may interrupt normal daytime activities or sleep, create anxiety, or reduce perception of general health. Though clinical practice guidelines for the management of BPH have been established, little research has been done to determine adherence to such guidelines. OBJECTIVE: To determine the preferences of urologists in the management of BPH in the VA population to assess compliance with established guidelines. METHODS: A self- administered mail survey was sent to about 300 urologists providing services to the VA population in approximately 145 VA medical centers across the US. The survey contained simulated cases of BPH patients, to determine urologists preferences for diagnostic tests and treatments recommended in the management of BPH. The survey also gathered information on frequency of failed initiation therapy and demographic and practice information. The survey was pilot tested for face and content validity among 10 urology residents. Descriptive statistics will be used to analyze the level of agreement among respondent urologists for diagnostic procedures and treatments recommended. Differences based on demographic and practice characteristics will also be determined. Urologists preferences will also be compared with clinical guidelines and responses of an expert panel. Failure rates for initiation therapy will also be determined using descriptive statistics. Published cost data for various diagnostic procedures will be used to estimate the mean cost of diagnosing BPH in the VA population. CONCLUSION: Study results will help us better understand how BPH is managed in the VA population. ECONOMIC & OUTCOMES RESEARCH METHODOLOGICAL ISSUES