Lower urinary tract symptoms suggestive of benign prostatic hyperplasia among Ghanaian men: a hospital-based cross-sectional prospective study

Abstract

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.

Correlation of prostate volume with severity of lower urinary tract symptoms as measured by international prostate symptoms score and maximum urine flow rate among patients with benign prostatic hyperplasia

“…The mean IPSS value in this study was 16.3 ± 7.1 which was slightly different from the findings by Kenneth et al [16] in Ghana and Ofoha et al in Jos, Nigeria [17]. This difference may be due to a relatively larger sample size in this study when compared with their own studies with sample size of 225 and 103 patients, respectively.…”

“…It also assesses the quality of life which has values from 0 (delighted) to 6 (terrible). Patients were categorized into three groups as mild (0-7), moderate (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) and severe (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) symptoms. Because it is a self-administered questionnaire and not translated in the local language, many patients who did not understand the questions or who could not read English required assistance.…”