An Analysis of Cases of Benign Prostatic Hyperplasia in a Tertiary Hospital in Eastern Nigeria: Incidence, Treatment, and Cost of Management (original) (raw)
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Background Benign prostatic hyperplasia (BPH) is the most common cause of bladder outlet obstruction and voiding symptoms in elderly men and it affects more than 50% of men over 60 years of age globally. Ethiopia is one of the top ten countries with the largest number of people affected by BPH in Africa, with a prevalence range of 6.1-33.4%. Methods A hospital based cross-sectional study was conducted among 143 male patients admitted at surgical ward of HUCSH and AGH of Hawassa City from Oct 15 to Nov 15 /2021. Non-randomized purposive sampling method was applied and the data were collected by using a pretested structured, an intervieweradministered questionnaire and patient review checklist. The collected data was checked daily for the completeness, the accuracy and the consistency and it was analyzed by SPSS version 20 and a binary logistic regression model was used to test the association between dependent and independent variables. Results This study included 143 male patients, with a mean age of 54.27 and SD ± 16.079 years. In this study the magnitude of BPH was 27(18.9%). Old age > = 75 years (AOR = 0.07; 95% CI: 0.005-1.024), being smokers (AOR = 0.261, 95% CI 0.078-0.871), positive familial history of BPH (AOR = 0.13; 95% CI: 0.038-0.428), patients with renal disease (AOR = 5.724; 95% CI: 1.669-19.631) and patients with history of di culties on sexual activity (AOR = 0.17; 95% CI: 0.034-0.830) were found to be statistically associated with the presence of BPH. Conclusions In conclusion, the ndings of this study revealed that BPH is a high prevalent disease among men. Factors that potentially increase the risk of benign prostatic hyperplasia were; old age, positive family history, smoking, and renal disease and di culties on sexual activities. Intensifying health education campaign to raise public awareness about, factors that potentially increase the risk of BPH, especially those modi able once.
INTRODUCTION Lower 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.
Histopathological review of Benign Prostatic Hyperplasia in Southern Tertiary Hospital of Nigeria
Aims and Objectives: This is to determine the age range of the lesion within our study; as a way to suggest possible recommendation(s). Materials/Methods: A sectional study of results of 463 patients within the study year (Jan 2005-Dec 2012) was obtained from the Dept. of Pathology register of the University of Calabar Teaching Hospital Calabar. These were analyzed using SPSS version 16 per each year. The result was represented in bar chats and pie chats respectively. Results: It showed that the ages of 50-60 years and 60-70 years are the worst vulnerable in the lesion (enlargement of prostrate) with its consequences of obstruction during micturition. Above the age of 70 years; only showed a significant rise in 2012 with 22% of patients indicated. Conclusion/recommendation: A better understanding of all risk factors (increasing age as per negroid race) and rates of clinical progression of benign prostatic hyperplasia (BPH) should be advocated – in terms of medical education of the c...
UROLOGIC DISEASES IN AMERICA PROJECT: BENIGN PROSTATIC HYPERPLASIA
The Journal of Urology, 2005
Purpose: Benign prostatic hyperplasia (BPH), the most common benign neoplasm in American men, is a chronic condition that is associated with progressive lower urinary tract symptoms and affects almost 3 of 4 men during the seventh decade of life. Approximately 6.5 million of the 27 million white men who are 50 to 79 years old in the United States in 2000 were estimated to meet the criteria for discussing treatment.
Clinical Features and Treatment of Benign Prostatic Hypertrophy at the Islamic Clinic of Ngaoundere
HEALTH SCIENCES AND DISEASES, 2020
Introduction. Obstructive prostatic enlargement is one of the major symptoms of the male urinary tract affection in elderly subjects and affects more than 200 million men throughout the world. When the medical treatment is not possible and surgery is proposed, endoscopic surgery is privileged. The surgery may be practiced through natural orifices, then we talk of transurethral resection. The aim of this study was to describe the socio-demographic profile of patients suffering from BPH at the Islamic clinic of Ngaoundéré Material and methods. We carried out a retrospective cross-sectional study that covered a period of three (03) years going from January 2017 to October 2019. Results. We identified 139 cases of transurethral prostate resection amongst which 29 cases were excluded from study because of the diagnosis of adenocarcinoma of the prostate gland. With a mean age sample of 66 years, the age group of 70-80 years was the most represented with a frequency of 35.5%. In this sample, 89.09% underwent a PSA test before surgery. Echography of the prostate gland revealed mostly the weights of 25g and 50g each with a frequency of 27.20%. One death was recorded out of the 110 patients enrolled giving a death rate of 0.90%. 11 patients in this sample presented prostate relapse either 11%. Conclusion. At last, we may note that, transurethral prostatic resection is a surgical technic of reference to the treatment of benign prostatic hyperplasia with several advantages compared to open surgery at islamic clinic of Ngaoundéré. RÉSUMÉ Introduction. L'hypertrophie prostatique obstructive est l'un des principaux symptômes des pathologies des voies urinaires chez les sujets âgés et affecte plus de 200 millions d'hommes dans le monde. Lorsque le traitement médical n'est pas possible et qu'une intervention chirurgicale est proposée, la chirurgie endoscopique est privilégiée. La chirurgie peut être pratiquée à travers des orifices naturels, puis on parle de résection transurétrale. Le but de cette étude était de décrire le profil sociodémographique des patients souffrant d'HBP à la clinique islamique de Ngaoundéré. Matériels et méthodes. Nous avons réalisé une étude rétrospective transversale couvrant une période de trois (03) ans allant de janvier 2017 à octobre 2019. Les données collectées ont été analysées par les logiciels Excel 2013 et XLSTAT version 2016. Résultats. Nous avons identifié 139 cas de résection transurétrale de la prostate dont 29 cas ont été exclus de l'étude en raison du diagnostic d'adénocarcinome de la glande prostatique. Avec un échantillon d'âge moyen de 66 ans, le groupe d'âge de 70 à 80 ans (35,5%) était le plus représenté. Dans notre population, 89,09% ont subi un test PSA avant la chirurgie. L'échographie de la prostate a révélé principalement des poids de 25g et 50g chacun avec une fréquence de 27,20%. Un décès a été enregistré sur les 110 patients inscrits donnant un taux de mortalité de 0,90%. Onze patients (11%) ont eu une récidive de l'adénome. Conclusion. La résection prostatique transurétrale est une technique chirurgicale de référence au traitement de l'hyperplasie bénigne de la prostate avec plusieurs avantages par rapport à la chirurgie ouverte à la clinique islamique de Ngaoundéré.
A Study of Effectiveness of Medical Therapy in Benign Prostatic Hyperplasia Patients in HUSM
Journal of Infectious Diseases and Therapeutics, 2015
Introduction: Benign prostate hyperplasia (BPH), a progressive disease, can cause various urinary complications if left untreated. Aims and Objective: The current study was desigined to compare international prostate symptom score (IPSS), urine flow rate (Qmax), Prostate specific antigen (PSA) in pre and post treatment among patients with Benign prostate hyperplasia and to asses their quality of life. Methodology: A cross sectional study was designed at Hospital Universiti Sains Malaysia, including all patients diagnosed as BPH from year 2007 to 2010. Based on inclusion and exclusion criteria 307 subjects were selected. New set of International Prostate Symptom Score (IPSS) and urine flow rate (Qmax) was obtained from all selected patients. SPSS version 19 was used for statistical analysis. Result: Out of the 307 patients currently treated at Hospital University Sains Malaysia (HUSM), 268(87.3%) were Malays, 38(12.4%) were Chinese and 1(0.3%) was Indian. Majority of the patients having BPH were above 50 years of age. One hundred and seven (34.9%) patients were associated with hypertension, followed by diabetes mellitus 12 (3.9%). urine peak flow rate (Qmax) had mean difference of 11.74 and 14.41ml/ sec, which shows the medical therapy do improve urine flow rate and benign prostatic hyperplasia (p<0.001). The prostate size also showed an increase having mean difference from 36.12 to 38.14cc 3 (p<0.001). There is significant relation between prostate gland volume and serum prostatic specific antigen (p<0.001). Conclusion: Benign prostatic hyperplasia although a benign condition, but still interferes with the normal life style of the patients. By initiating medical treatment this disease can not only be treated but also significantly improves the quality of life of the patients.
The Lancet Healthy Longevity
Background Benign prostatic hyperplasia is a common urological disease affecting older men worldwide, but comprehensive data about the global, regional, and national burden of benign prostatic hyperplasia and its trends over time are scarce. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated global trends in, and prevalence of, benign prostatic hyperplasia and disability-adjusted life-years (DALYs) due to benign prostatic hyperplasia, in 21 regions and 204 countries and territories from 2000 to 2019. Methods This study was conducted with GBD 2019 analytical and modelling strategies. Primary prevalence data came from claims from three countries and from hospital inpatient encounters from 45 locations. A Bayesian metaregression modelling tool, DisMod-MR version 2.1, was used to estimate the age-specific, location-specific, and yearspecific prevalence of benign prostatic hyperplasia. Age-standardised prevalence was calculated by the direct method using the GBD reference population. Years lived with disability (YLDs) due to benign prostatic hyperplasia were estimated by multiplying the disability weight by the symptomatic proportion of the prevalence of benign prostatic hyperplasia. Because we did not estimate years of life lost associated with benign prostatic hyperplasia, disabilityadjusted life-years (DALYs) equalled YLDs. The final estimates were compared across Socio-demographic Index (SDI) quintiles. The 95% uncertainty intervals (UIs) were estimated as the 25th and 975th of 1000 ordered draws from a bootstrap distribution. Findings Globally, there were 94•0 million (95% UI 73•2 to 118) prevalent cases of benign prostatic hyperplasia in 2019, compared with 51•1 million (43•1 to 69•3) cases in 2000. The age-standardised prevalence of benign prostatic hyperplasia was 2480 (1940 to 3090) per 100 000 people. Although the global number of prevalent cases increased by 70•5% (68•6 to 72•7) between 2000 and 2019, the global age-standardised prevalence remained stable (-0•770% [-1•56 to 0•0912]). The age-standardised prevalence in 2019 ranged from 6480 (5130 to 8080) per 100 000 in eastern Europe to 987 (732 to 1320) per 100 000 in north Africa and the Middle East. All five SDI quintiles observed an increase in the absolute DALY burden between 2000 and 2019. The most rapid increases in the absolute DALY burden were seen in the middle SDI quintile (94•7% [91•8 to 97•6]), the low-middle SDI quintile (77•3% [74•1 to 81•2]), and the low SDI quintile (77•7% [72•9 to 83•2]). Between 2000 and 2019, age-standardised DALY rates changed less, but the three lower SDI quintiles (low, low-middle, and middle) saw small increases, and the two higher SDI quintiles (high and high-middle SDI) saw small decreases. Interpretation The absolute burden of benign prostatic hyperplasia is rising at an alarming rate in most of the world, particularly in low-income and middle-income countries that are currently undergoing rapid demographic and epidemiological changes. As more people are living longer worldwide, the absolute burden of benign prostatic hyperplasia is expected to continue to rise in the coming years, highlighting the importance of monitoring and planning for future health system strain. Funding Bill & Melinda Gates Foundation.
The American journal of managed care, 2006
To examine utilization and costs of care for benign prostatic hyperplasia (BPH)-related services in a large cohort of commercially insured persons. Pharmacy and medical claims data were obtained from 61 US healthcare plans. Men aged > or = 45 years who were newly diagnosed with BPH between January 2000 and March 2001 were identified. Each patient was followed for 12 months after diagnosis; utilization and costs were calculated for common procedures and disease-related events. Costs were estimated based on health plan payments. Univariate statistics were provided for relevant measures. A total of 77 040 patients were selected (mean age, 58.1 years). Thirty-six percent of patients had 1 or more urologist visits in the year after diagnosis. Two thirds of patients had a prostate-specific antigen test, whereas 7% had a prostate biopsy. A total of 14 392 patients (18.7%) received an alpha blocker during follow-up; 1860 patients (2.4%) received a 5-alpha reductase inhibitor. Approximate...
2011
Given the ageing of western populations, the cost burden associated with the treatment of LUTS suggestive of BPO will increase substantially over the next few decades. Therefore, from the economic perspective, the primary objective of the Triumph project is the assessment of the cost-effectiveness of treatment options for lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO), formerly referred to as symptomtic benign prostatic hyperplasia (BPH), in medical practice in initially six European countries. All modalities of LUTS treatment used in these countries will be considered. The effectiveness and costs associated with these treatments will be assessed in each country. Data will be gathered from observed medical practice rather than in the setting of a trial. Country-specific aspects will be studied and the outcome of country-specific policies can be predicted. Patient quality of life will also be measured using the I-PSS score as a basis. A number of treatment scenarios will be assessed in terms of both their costs and long-term effects, using a computer simula-tion. These economic analyses will provide greatly improved insight into the most cost-effective treatments for LUTS suggestive of BPO.