Quality of Life of Benign Prostatic Enlargement Patients Undergoing Treatment with Tamsulosin at Muhimbili National Hospital

Abstract

Introduction: Benign prostatic enlargement (BPE) is a condition that most commonly occurs in aging males between the ages of 50 to 90years.The condition cause slower urinary tract symptoms (LUTS) which is the most common presentation at various urological clinics. Most of the patients with mild to moderate symptoms diagnose dusing the international prostate symptom score (IPSS) are usually treated medically. Tamsulosin is an alpha adrenergic receptor blocker mostly used in the medical treatment of BPE in Tanzania. Broad Objective: To evaluate the quality of life and improvement of symptoms of BPE patients undergoing treatment with Tamsulosin at MNH. Methodology: This was quasi pre and post-test Study design to investigate the quality of life of BPE patients undergoing treatment with Tamsulosin at MNH. A structured questionnaire was used to assess symptoms before treatment with Tamsulosin and three months after treatment, evaluation included improvement of symptoms and quality of life, and side effects associated with use of Tamsulosin. Patients were followed up monthly for three months. Data were analyzed by SPSS version 20; Chi-square test was conducted to determine the association between the proportions of social demographic characters, IPSS, quality of life and side effects. The p< 0.05 was considered statistically significant. Results: A total of 192 patients were enrolled in the study, 39 patients were drop outs from the study, due to incomplete follow up, 153 patients were available for analysis after three months. Mean age was 67.67(±6.64). There was an improvement in symptoms after three months of use of Tamsulosin from Initially 3.3%, mild, 96.7% moderate symptoms to61.45% had (no or mild symptoms), 32.7% (moderate symptoms), and5.9% (progressed to severe symptoms) In terms of quality of life before treatment50.3% of participants were dissatisfied with their quality of life, and 49.7% of participants considered their quality of life to be terribleor unhappy. Three months after treatment 61.4% of participants had either felt delighted, pleased or happy with their quality of life and 32% had remained dissatisfied with their quality of life while 6.5% had still experienced terrible or unhappy quality of life. Improvement of symptoms and QOL were not associated with prostate size or residual urine volume. Enumerated side effects, with the use of Tamsulosin, were as follows; headache (9.8%), dizziness (9.2%), poor ejaculation (2.6%) and nausea (2.6%). Conclusion: Both Quality of life and international prostate symptom score improved 3 months after Tamsulosin use. In this study prostate sizeand residual volume were not associated with outcome on use of the drug. Few side effects were observed during the treatment of BPE with the use of Tamsulosin. Recommendations: Tamsulosin should continue to be used as a medical therapy for patients with benign prostatic enlargement with lower urinary tracts symptoms given the improvement in both qualities of life and prostate symptoms