Prevalence of clinical benign prostatic hyperplasia amongst community-dwelling men in a South-Western Nigerian rural setting: A cross-sectional study

Abstract

Objectives To determine the prevalence of benign prostatic hyperplasia (BPH) and correlates International Prostate Symptom Score (IPSS), peak/maximum flow rate (Qmax), quality of life (QoL) score and prostate volume (PV) amongst male adults in a rural setting in Nigeria. Subjects and methods This is a community-based cross-sectional survey conducted amongst 615 men. Subjects selected using multi-staged sampling technique were interviewed for presence of lower urinary tract symptoms (LUTS) in their houses. Severity of symptoms was assessed using International Prostate Symptom Score (IPSS) questionnaire. Digital rectal examination (DRE), uroflowmetry and prostate scan were carried out in nearby primary health centres. Criteria for diagnosis of BPH were prostatic volume ≥ 30 cm3 with moderate/severe LUTS and/or Qmax < 15 mL. Relationships between variables were determined using Pearson's Chi-squared and Fisher's exact tests. Results The overall prevalence of LUTS was 57.4% while 28.5% had moderate-to-severe IPSS with average score of 12.3 ± 5.2. More than half (56.1%) reported impaired QoL with average score of 3.4 ± 1.3. The DRE and ultrasound prevalences of enlarged prostate were 68.3% and 64.9% respectively. About 29% had abnormal Qmax. Both QoL and Qmax had significant relationship with IPSS (p < 0.001) while none exists between prostate size and IPSS (p = 0.339). The overall prevalence of BPH was 237 per 1000 men (23.7%). The age-specific prevalence rates increased from 104 per 1000 men in the fifth decade to 429 per 1000 in men >90 years. Conclusion The burden of clinical BPH is very high amongst Nigerian men and the prevalence increases with age. There is need for more public awareness because of the significant impairment in the QoL associated with BPH symptoms.