Patient-reported Outcomes Following Medical Management of Benign Prostate Hyperplasia in a Tertiary Care Setting: Insights from BSMMU
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Keywords
Benign Prostatic Hyperplasia, BPH, IPSS, Irritative symptoms, Patient-reported outcomes, Quality of life.
Abstract
Background: Benign Prostatic Hyperplasia (BPH) is a prevalent urological condition that significantly impairs the quality of life of aging men. Evaluating patient-reported outcomes following medical management is crucial for understanding treatment effectiveness in real-world clinical settings. Objective: To assess the changes in symptom severity and quality of life following a structured, stepwise protocol for the medical management of BPH at a tertiary care hospital. Methods: This prospective interventional study was conducted at the Department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from January 2020 to December 2021. A purposive sample of 105 patients aged 45-60 years with confirmed BPH was enrolled. Participants received Tamsulosin (0.4 mg), with escalation to Silodosin (8 mg) and/or Dutasteride (5 mg) for insufficient response. Bladder sedatives were used for irritative symptoms. Outcomes were assessed using IPSS and QoL scores at baseline and 3, 6, 9, and 12-month intervals. Data analysis was performed with SPSS version 23.0. Results: Analysis demonstrated significant improvement in all outcomes. Mean total IPSS decreased markedly from baseline to 12 months (19.5 ± 3.8 to 8.7 ± 2.5, p<0.001). Quality of life and uroflowmetry parameters (Qmax) also improved significantly (p<0.001). Over 80% of patients reported satisfaction with treatment. While 64.8% responded to initial monotherapy, escalation to combination therapy in non-responders was highly effective. The adverse event profile was favorable. Conclusion: A stepwise medical management protocol for BPH significantly improves patient-reported symptoms, quality of life, and objective flow parameters. This approach is highly effective and well-tolerated in a tertiary care setting, with high patient satisfaction.
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Dr. Mohammed Rafiqul Islam
Medical Officer, Department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Dr. Md. Jahangir Hossain
Medical Officer, Department of Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Dr. Md. Mostafizur Rahaman
Research Assistant, Department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Dr. Samira Chowdhury
Medical Officer, Department of Gyne & Obs, Institute of Child and Mother Health (ICMH), Matuail, Dhaka, Bangladesh.
Dr. Ahmed Sami Al Hasan
Medical Officer, Department of Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh.