Clinicodemographic Profile and Determinants Associated with Outcomes Among Patients with Benign Prostatic Hyperplasia in Mangalore City of South India: A Retrospective Multi-hospital-based Study
Nitin Joseph, Prajwal P. Ravinder, Aishwariya Lakshmi Narasimhan, Kaushiki Jain, Ananya Rai, Vibhuti Kumar, Shreyash Varshney, Saksham Arora, Abhay Lalit Goel, Amreen HussainIntroduction:
Benign Prostatic Hyperplasia (BPH) is a common cause of Lower Urinary Tract Symptoms (LUTS) among ageing men. This study was therefore conducted to study the clinical features, complications, and management practices of BPH. Also, it was done to identify the determinants associated with increased symptom severity, complications, and non-recovery status among BPH patients.
Methods:
This retrospective study used one year of data collected from the medical records of 156 BPH inpatients at two tertiary care hospitals in Mangalore. Determinants of the outcome variables, severity of International Prostate Symptom Score (IPSS), complications, and non-recovery status following management, were assessed using the binary logistic regression analysis model.
Results:
The mean age of the patients was 66.5 (SD 12.2) years. The mean age at diagnosis was 65.6 (SD 11.9) years. IPSS suggestive of moderate-to-severe BPH was present among 111 (71.1%) patients. The most common complication of BPH was urinary tract infection [36 (23.1%)]. Seventynine (50.6%) patients were on pharmacological management. Seventy-seven (49.4%) patients were on surgical management. Among them, 76 (98.7%) underwent Transurethral Resection Of The Prostate (TURP). Severe IPSS was more common among BPH patients with diabetes mellitus (DM) (p =0.015). Complications such as renal failure (p =0.03), bladder diverticula (p =0.003), increased Blood Urea Nitrogen (BUN) (p =0.006), and serum hyponatremia (p =0.031) were associated with severe IPSS. The nonrecovery status following management was significantly greater among those with below-poverty-line status (p =0.042), dyslipidaemia (p =0.004), and bladder diverticula (p =0.006).
Discussion:
There is a need to spread awareness of BPH, particularly among middle-aged men, regarding its common signs and symptoms observed in this study, so that they can seek timely healthcare services. Considering the high prevalence of DM currently seen among males in India, it becomes essential to identify BPH among them, as DM was associated with the increased severity of BPH. Increased risk of life-threatening complications such as renal failure and increased BUN among patients with severe BPH further emphasizes the need for its early identification and timely management.
Conclusion:
The mean age of BPH diagnosis was delayed. Therefore, people, particularly those in high-risk groups, need to be made aware of their symptoms and signs to seek early treatment. The IPSS was moderate-to-severe among the majority of BPH patients, possibly indicating their delayed health-seeking behaviour. Several determinants were found to influence outcomes in BPH patients, which need to be controlled for a better prognosis following management.