Prevalence of benign Prostate Hyperplasia among middle aged adults in Puducherry

 

Ms. Pushpa B1, Prof. Dr. Nivethitha2, Prof. Dr. A. Felicia Chitra3

1M.SC. Nursing II Year (MSN), MTPG and RIHS, Puducherry.

2Associate Professor, Medical Surgical Department, MTPG and RIHS, Puducherry.

3Principal Cum Hod-Dept of Medical Surgical Nursing, MTPG and RIHS, Puducherry.

*Corresponding Author Email: nivi.mahi@yahoo.co.in

 

ABSTRACT:

The aim was to understand the prevalence of Benign Prostate Hyperplasia in men aged 49 years or older in Puducherry through a descriptive study and analyze the correlation with epidemiologic factors. 30 participants were selected according to the inclusion and exclusion criteria by systematic random sampling technique. A descriptive research design was used for the study. Data was collected using IPSS-Q8 among the male participants attending the Urology OPD at Government Hospital, Puducherry between the age group of 49 years and above. Data analysis was done using descriptive statistics and inferential statistics. Out of the 30 male participants, majority of the male participants 14 (46.7%) of study population were in the age group between 60-69 years. the overall results of the study show that most of the male participants 17 (56.7%) had severe level of benign prostate hyperplasia and 13 (43.3%) male participants had moderate level of benign prostate hyperplasia under the age group of 49-90 years. the demographic variables diet has shown statistically significant association with the prevalence of benign prostate Hyperplasia among the selected participants with chi-square value of (2=4.22, d. f=1) at p<0.05 level. The study concluded stating that Benign Prostate Hyperplasia is the most common disease among aging males and it is a need to be addressed as earlier as possible because the geriatric population is on the rise in this generation.

 

KEYWORDS: Benign Prostate Hyperplasia, middle aged adults, Prevalence.

 

 

INTRODUCTION:

Benign Prostate Hyperplasia is the most common urological problem of ageing men, manifested as severe obstruction in urinary flow with discomfort and pain. Benign Prostate Hyperplasia is a complex disease from the etiological and pathogenesis point of view. A recent AUA guideline (2003) suggests an increase in the incidence of Benign Prostate Hyperplasia worldwide and predicts by the age of 60 years, more than 50% of men will have microscopic evidence of the disease and by the age of 85 years, as many as 90% of men will be affected1. Worldwide investigations for incidence of Benign Prostate Hyperplasia are scanty and at times difficult to compare due to uneven definition of Benign Prostate Hyperplasia based on different clinical parameters. There is also great geographical disparity in prevalence and degree of severity of symptoms of Benign Prostate Hyperplasia2.

 

In India, 6.7–14% prevalence Benign Prostate Hyperplasia was reported in hospital and community studies. Barry et al. have reported a symptom index to evaluate the severity of lower urinary tract infection symptoms3. Studies conducted in India have used the international prostate symptom score tool (IPSS) to report the symptoms severity but not validated in Indian populations. In this study, the researcher made an attempt to report the prevalence of lower urinary tract infection symptoms in the population belonging to the state of Puducherry. In 14% of men with lower urinary tract infection symptoms, clinical progression in terms of worsening lower urinary tract infection symptoms, acute urinary retention, urinary incontinence, renal insufficiency, or recurrent urinary tract infection were observed over a period of 5 years. The progression was shown to result in the severity of lower urinary tract infection symptoms, increased prostate size, and elevated levels of prostate specific antigen, as well as lowered rate of urinary flow4,5.

 

Benign prostate hyperplasia is the most common disease among aging males, but no reports have addressed the prevalence of Benign Prostate Hyperplasia in Puducherry. Therefore, the researcher aims to understand the prevalence of Benign Prostate Hyperplasia in men aged 49 years or older in Puducherry through a descriptive study and analyze the correlation with epidemiologic factors. A persistent challenge in the interpretation of data from population-based studies of Benign Prostate Hyperplasia is the heterogeneity of the case definitions in the literature6,7.

 

MATERIALS AND METHODS:

Quantitative research approach and non-experimental one group pre-test post-test design was selected for this study. A total number of 30 samples who full-filled the inclusion criteria were selected from out-patient department at selected hospitals, Puducherry by using systematic random sampling technique. The study was conducted for the period of 1 week. The tool used in this study was IPSS-Q89,10. The participants who were included for the study were: Male participants between the age group of 49 years and above, attending the Urology OPD at Government Hospital of Puducherry, Participants who are willing to participate, and Participants who can understand Tamil OR English. The participants who were excluded from the study were: Urology male participants who are not willing to participate in the study, Participants with neurological disorders.

 

RESULTS:

Most of the male participants 17 (56.7%) had severe level of benign prostate hyperplasia and 13 (43.3%) male participants had Moderate level of benign prostate hyperplasia under the age group of 49-90 years and the mean and standard deviation of prevalence of benign prostate hyperplasia among the selected male participants attending urology OPD was (20.43+6.39). (Figure-1)

 

Fig: 1. Percentage wise distribution of prevalence of benign prostate hyperplasia (BPH) among the selected male patients attending urology OPD.

 

The association of prevalence of Benign Prostrate Hyperplasia with the selected demographic variable was assessed and the results revealed that there is no significant association between these two variables except diet which had shown significant association with chi-square value of (c2=4.22, d.f=1) at p<0.05 level. (Table-1)

 

Table 1: Association of the prevalence of benign prostate hyperplasia among the selected male participants attending urology OPD with their selected demographic variables.

Sl. No

Demographic variables

Prevalence of benign prostate hyperplasia

X2

Df

p-value

Moderate

Severe

N

%

N

%

1

Age (in years)

 

49-59 years

4

44.4

5

55.6

0.006

2

0.997

60-69 years

6

42.9

8

57.1

70 years and above

3

42.9

4

57.1

2

Educational status

 

None

3

37.5

5

62.5

0.230

2

0.892

Elementary

8

47.1

9

52.9

High school

2

40

3

60

Graduate

0

0

0

0

3

Occupation

 

Private employee

11

45.8

13

54.2

0.305

1

0.580

Government employee

2

33.3

4

66.7

4

Religion

 

Hindu

10

40

15

60

0.814

2

0.665

Muslim

1

50

1

50

Christian

2

66.7

1

33.3

5

Diet

 

Vegetarian

1

12.5

7

87.5

4.22

1

0.040*

Non-vegetarian

12

54.5

10

45.5

6

Personal habit

 

None

0

0

3

100

3.02

2

0.221

Alcohol

2

66.7

1

33.3

Smoking

0

0

0

0

Both alcohol and smoking

11

45.8

13

54.2

 

Table 2: Frequency and Percentage wise Distribution of Demographic Variables among male patients.

Sl. No

Demographic Variables

Frequency (n)

Percentage (%)

1

Age (in years)

 

49-59 years

9

30

60-69 years

14

46.7

70 years and above

7

23.3

2

Educational status

 

None

8

26.7

Elementary

17

56.7

High school

5

16.6

Graduate

0

0

3

Occupation

 

Private employee

24

80

Government employee

6

20

4

Religion

 

Hindu

25

83.3

Muslim

2

6.7

Christian

 

3

10

5

Diet

 

Vegetarian

8

26.7

Non-vegetarian

22

73.3

6

Personal habit

 

None

3

10

Alcohol

3

10

Smoking

0

0

Both alcohol and smoking

24

80

 

Frequency and Percentage wise Distribution of Demographic Variables among male participants revealed that, out of the 30 male participants, majority of the male participants 14 (46.7%) of study population were in the age group between 60-69 years. 17 (56.7%) had received elementary education, 24 (80%) belonged to private employee category, 25 (83.3%) belonged to the Hindu religion, 22 (73.3%) were non–vegetarians, 24 (80%) had both alcohol and smoking habits. (Table-2)

 

DISCUSSIONS:

The study results reveal that most of the male participants 17 (56.7%) had severe level of benign prostate hyperplasia and 13 (43.3%) male participants had Moderate level of benign prostate hyperplasia under the age group of 49-90 years and the mean and standard deviation of prevalence of benign prostate hyperplasia among the selected male participants attending urology OPD was (20.43+6.39).

 

BPH is the most common urological problem of ageing men, manifested as severe obstruction in urinary flow with discomfort and pain. BPH is a complex disease from the etiological and pathogenesis point of view. A recent AUA guideline (2003) suggests an increase in the incidence of BPH worldwide and predicts by the age of 60 years, more than 50% of men will have microscopic evidence of the disease and by the age of 85 years, as many as 90% of men will be affected. Worldwide investigations for incidence of BPH are scanty and at times difficult to compare due to uneven definition of BPH based on different clinical parameters. There is also great geographical disparity in prevalence and degree of severity of symptoms of BPH. However, the actual current incidence of BPH will require valid scientific evidence from pooled data, and India as a whole lacks a large-scale screening database of patients diagnosed for any prostatic disease11,12.

 

Another study which supports the present study is by Zhang w et al (2019) who conducted a longitudinal study on prevalence of lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH)8 using the Secondary analysis of a cohort sample giving the result concluding the weighted overall prevalence of LUTS/BPH was 10.66% (95% CI 9.36 to 12.12). Among individuals aged over 70 years, the prevalence was 14.67% (95% CI 11.80 to 18.09) and it increased with ageing (p<0.05). The prevalence of LUTS/BPH among subjects residing in urban areas was higher (13.55%, 95% CI 10.95 to 16.64) than those living in rural areas (8.38%, 95% ci 6.90 to 10.15). The prevalence of LUTS/BPH was lowest in the south-central and south-west regions and highest in the north-west region. They found an increasing trend of prevalence of LUTS/BPH with ageing. It varied according to marital status, socioeconomic status and geographical region.

 

CONCLUSION:

Among all the health personnel’s, Nurses are always in contact with the clients, and it is the responsibility of the nurses to take an active part in promotion of Health and Prevention of illness in the clinical setting and in the community. The implications drawn from the present study can be vital concern to the health care team including the professional nurse practitioners, nurse educators, nurse administrators and nurse researchers. The present study enables the male geriatric population to gain knowledge on benign prostate hyperplasia.

 

Benign Prostate Hyperplasia is the most common disease among aging males and it needs to be addressed as earlier as possible because the geriatric population is on the rise in this generation.

 

CONFLICT OF INTEREST:

The authors declare that they have no conflict of interest related to the publication of this article.

 

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Received on 18.06.2020         Modified on 01.08.2020

Accepted on 08.09.2020      ©A&V Publications All right reserved

Asian J. Nursing Education and Research. 2020; 10(4):409-412.  

DOI: 10.5958/2349-2996.2020.00087.7