Background:Lower urinary tract symptoms (LUTSs) can significantly reduce men's quality of life and may point to serious pathology of the urogenital tract. This study aimed at finding predictors of symptoms score on the International Prostate Symptom Score (IPSS) for patients with LUTS.Materials and Methods:The study was cross-sectional conducted among 225 Ghanaian men visiting the urology clinic at Komfo Anokye Teaching Hospital. Trained interviewers used the IPSS, which adds a quality of life question to the American Urology Association symptom index to determine the extent to which patients are troubled by their symptoms. Five milliliters of blood was collected for total prostate-specific antigen (PSA) measurement. Transrectal ultrasonography was performed to evaluate the prostate volume (PV).Results:The mean age of the participants was 67.96 ± 14.57. The average score obtained from the study participants using the IPSS scale was 17.52 ± 7.83. There was a significant association between bother score and IPSS symptoms grade (P < 0.0001). Regression plot of the participants' points for IPSS in relation to the age, PSA, and PV showed statistically significant positive associations (P < 0.05). However, the coefficients of determination (R2) were 0.156, 0.022, and 0.048, respectively. This means that each unit increase of age, PSA, and PV only influences 15.6%, 2.3%, and 4.8% of the change in the symptom score. There was statistically significant association between age and moderate-to-severe LUTS with age range of 75 years above recording the highest odds (adjusted odds ratio (AOR) = 18.72, (1.15–99.78), P < 0.0001). The PSA range 20.1–50 ng/ml was significantly associated with moderate-to-severe LUTS (AOR = 17.37 (2.19–223.45), P = 0.006). Moreover, other factors, which were significantly associated with moderate-to-severe LUTS, were smoking (AOR = 0.32 (0.11–0.94) P = 0.038) and being widowed (AOR = 0.05 (0.002–0.52), P =0.010) respectively.Conclusion:The study found a statistically significant correlation between age, PSA, PV, and IPSS scores; however, these influences were mild.

INTRODUCTIONLower urinary tract symptoms (LUTS) of benign prostatic hyperplasia (BPH) are common clinical presentation in elderly men. It affects 15-60% of patients greater than 40 years which poses public health burden. 1,2 LUTS are used to define the complex of those symptoms which includes bladder storage, sensation or voiding symptoms. These symptoms are often associated with prostate enlargement which is a common aetiology of ABSTRACT Background: Lower urinary tract symptoms (LUTS) of benign prostatic hyperplasia (BPH) are common in the elderly. This study sought to determine the prevalence of LUTS among patients visiting the urology clinic at Komfo Anokye Teaching Hospital, Kumasi, Ghana and to explore its presentation patterns. Methods: Simple randomized sampling technique was used to recruit 225 subjects with a mean age of 67.96±14.57 (range=40-100years) in a prospective cross-sectional study. LUTS related characteristics and international prostate symptom score (IPSS) questionnaire were employed to obtain relevant data. Results: The average IPSS of the studied participants was 17.52±7.83. Based on the IPSS, the prevalence of LUTS suggestive of BPH was 88.89%. Bladder storage symptoms were also recorded at 88.59% whilst prostate enlargement based on digital rectal examination (DRE) was 60.4% among the studied subjects. PSA levels ≥4.0ng/ml gave a prevalence of 81.5%. The prevalence of prostate enlargement defined as PSA ≥1.5ng/ml was 85.23% among the studied subjects whilst 63.11% of the subjects examined had troublesome LUTS. Urgency was the most predominantly reported LUTS (93.3%) among the subjects studied. Conclusions: This study has clearly shown that, the most prevalent urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia were bladder storage symptoms and urgency. These symptoms when present clinically therefore, suggest benign prostatic hyperplasia and that the prevalence estimates of LUTS in older men are relatively higher at diagnosis.

The effect of ethanol leaf extract of Gnetum africanum was studied in albino rats induced with benign prostatic hyperplasia. The animals (36) were randomly grouped into six with six rats in each group. Testosterone and oestradiol every other day for 28 days was used to induce hyperplasia. The test groups (2 -4) were treated with 200, 400 and 800 mg/kg body weight of extract for another 28 days. Group 5 was given the standard drug while group 6 served as negative control. At the end of the treatment period, the rats were sacrificed under anesthesia and blood samples collected for biochemical analysis. The results showed that in the animals exposed to the inducing agents increased significantly (p <0.05) in activity of MDA, ACP and PSA levels whereas there was a significant (p >0.05) decrease in the activities of GR, CAT and SOD as compared with the normal control. However, treatment with ethanol leaf extract of G. africanum showed significant (p >0.05) increase in the activities of the antioxidant enzymes and significant (p >0.05) decrease in the level of MDA, ACP and PSA in a dose dependent manner as comparable to the normal control. These findings are indication that the extract of G. africanum has potential remedial effects on benign prostatic hyperplasia.

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