Effect of medical treatment on outcome of Benign Prostatic Hyperplasia (BPH) in patients followed in University Teaching Hospital of Kigali (CHUK)

Abstract

Abstract Background The management of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) requires careful approach. The initial choices in the management of LUTS due to Benign Prostatic Hyperplasia include watchful waiting, pharmacotherapy and surgical intervention. The aim of this study is to determine the effect of medical therapy on adult male patients with LUTS secondary to BPHMethods It was a prospective observational study for a period of 1year of men over 40 years with Lower Urinary Tract Symptoms due to BPH diagnosed clinically. The enrollment was done through the out-patient clinic of urology unit and a follow up at 1,3 and 6months was done. We recorded variables like, Post-void residual urine (PVR), Prostate size, International Prostate Symptom Score (IPSS), medication taken, etc. We described clinical and demographic characteristics using mean, standard deviation (SD), median, interquartile range (IQR), frequency, and percentage. The bivariate and multivariate logistic regression analyses were used to assess the relationship between medical treatment and the outcomes of interestResults A total of 163 patients were enrolled. Their mean age were 68years(SD = 8.6), The adherence to treatment was 151/154 (98.05%) in month 1 and 133/151 (88.08%) in month 6. The reason of no adherence was ignorance in 11/17(64.7%); drug was not available 3/17(17.6%), and 2/17(11.8%) were lucking money. Taking both monotherapy and combined therapy were associated with decrease in IPSSS score of more than 4points after 3 months and the relationship was statistically significant after adjusting to the initial prostate size as a confounder (pValue = 0.01(OR = 59.2) and pValue = 0.02(OR:13.8) respectively. The medical treatment was associated with mean decrease in PVR of 61ml and 94ml respectively after 3 months and 6months. The latter association was statistically significant in a bivariate analysis (pValue: 0.03 at 3month and pValue:0.04 at 6months).Conclusion medical treatment for BPH was associated with a significant reduction in IPSS after 3 months, which was consistent after 6 months. The reduction in PVR was observed after 3 and 6 months, but the relationship was not statistically significant after adjusting for the baseline IPSS score.