The impact of medical therapy for benign prostatic obstruction on the health-related quality of life at Muhimbili National Hospital

Abstract

ABSTRACT

Background; Benign prostatic obstruction (BPO) is a common condition in older men that can often result in lower urinary tract symptoms (LUTS). LUTS associated with BPO can cause bladder outlet obstruction may have a significant negative impact on patients’ health-related quality of life as can certain treatments for the condition.

Objective: To determine the impact of medical therapy on health-related quality of life among patients on treatment for lower urinary tract symptoms due to benign prostatic enlargement at MNH.

Methodology: A prospective hospital based descriptive study was carried out in urology outpatient clinics. Both public and private clinics from April to December 2017. All diagnostic and treatment options of patients were decided by attending clinicians. Patients were ≥30 years of age on medical treatment for LUTS due to BPO. Symptom and HRQL were measured at baseline and at 3 months using the international prostate symptom score (IPSS) and the Benign Prostatic Hyperplasia Impact Index (BII) score tools.

Results: A total 150 patients were included in the analysis with median age was 54.6 years ,mean PSA of 4.45ng/ml (SD5.13) and a mean prostate volume 54.62cc (SD5.13).Majority, 144(96%) had moderate and severe LUTS. Majority, 94(63%) men received a combination of tamsulosin and finasteride and 44(29%) men received tamsulosin. Pytotherapy or its combination with finasteride were prescribed to few (7%). Medical therapy was associated with overall improvement of quality of life (p<0.001). Tamsulosin and combination of tamsulosin and finastride were equally effective in improving symptom and QoL. A combination of tamsulosin and finasteride was associated with more adverse effects.

Conclusion: Improvements in QoL and symptoms was noted across the medical treatments most widely used in real-life practice at MNH to manage patients with LUTS for BPO. Tamsulosin showed an equivalent efficacy to a combination of tamsulosin and finasteride at third month of therapy with fewer adverse effects than combination therapy.