Effect of medical treatment on outcome of benign prostatic hyperplasia in patients followed in the University Teaching Hospital of Kigali

Abstract

INTRODUCTION: Management of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) includes watchful waiting, pharmacotherapy, and surgical intervention. This study aimed to determine the effect of medical therapy on LUTS in patients with BPH in Rwanda. 

METHODS: This was a one-year prospective observational study in men over 40 years with LUTS due to BPH. Patients were followed at 1, 3, and 6 months. We recorded post-void residual urine (PVR), prostate size, International Prostate Symptom Score (IPSS), and BPH medications. Logistic regression analyses were used to assess the relationship between medical treatment and outcomes of interest. 

RESULTS: A total of 163 patients were enrolled. Adherence to treatment was 151/154 (98%) at one month and 133/151 (88%) at 6 months. The reason of no adherence was ignorance in 11/17 (65%), drug was not available 3/17 (18%), and 2/17 (12%) were lacking money. 

Medical therapy was associated with a decrease in IPSS score of more than 4 points after 3 months and the relationship was statistically significant after adjusting to the initial prostate size as a confounder (p =0.01 and p=0.02, respectively). Medical treatment was also associated with mean decrease in PVR at 3 and 6 months, respectively (p: 0.03 at 3 month and p 0.04 at 6 months). 

CONCLUSION: Medical treatment for BPH was associated with decreased IPSS and PVR in Rwanda. Medical therapy offers an alternative to surgical treatment in low-resource areas with limited surgical services. Advocacy efforts should focus on ensuring affordable access to these medications.