Prevalence, associated factors, clinical manifestations, and complications of symptomatic benign prostatic hyperplasia among adult men attending two general hospitals in the Benishangul-Gumuz Region, Ethiopia: a retrospective cross-sectional study
This retrospective cross-sectional study of 240 men in the Benishangul-Gumuz Region of Ethiopia found a 17.9% prevalence of symptomatic benign prostatic hyperplasia, identifying older age, khat chewing, diabetes mellitus, kidney disease, and family history as significant independent predictors associated with substantial lower urinary tract symptoms and complications.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
For many men, the simple act of passing urine becomes a source of worry as they grow older. This concern often stems from a condition called benign prostatic hyperplasia, a non-cancerous enlargement of the prostate gland. The prostate is a small organ located just below the bladder, surrounding the tube that carries urine out of the body. As men age, this gland can grow larger, squeezing the urethra and making it difficult for urine to flow freely. The result is a collection of symptoms known as lower urinary tract symptoms, which include needing to urinate frequently, feeling a sudden and urgent need to go, waking up multiple times at night to use the bathroom, or feeling that the bladder never fully empties. While this condition is common worldwide and rarely life-threatening, it can significantly disrupt daily life and, in severe cases, lead to serious complications like kidney damage or the inability to urinate at all. Understanding who is most likely to develop these symptoms and why is crucial for doctors to provide better care, yet in many parts of the world, including Ethiopia, detailed information about how this condition affects local populations has been scarce.
To fill this gap in knowledge, researchers conducted a study at two general hospitals in the Benishangul-Gumuz region of Ethiopia. They looked back at the medical records of 240 men who were forty years of age or older and had visited these hospitals between 2020 and 2023. By reviewing these files, the team aimed to determine how common symptomatic prostate enlargement was in this specific area, what symptoms the men experienced, and what factors might be linked to the condition. The study focused on men who had been diagnosed with the condition and were experiencing symptoms, rather than just those with an enlarged prostate who felt fine. The researchers gathered information on the patients' ages, where they lived, their habits, and their medical history, including whether they had diabetes, kidney disease, or a family history of the same problem. They also noted if the men chewed khat, a leafy plant commonly chewed in the region for its stimulant effects.
The investigation revealed that nearly one in five men in the study group, specifically 17.9 percent, suffered from symptomatic benign prostatic hyperplasia. The likelihood of having the condition rose sharply with age. While very few men in their forties were affected, the rate climbed significantly for those in their sixties and seventies, reaching a high of 60 percent among men aged seventy-five and older. Among the men who did have the condition, the most frequent complaints were the need to urinate often, a sudden urge to go, the sensation of incomplete emptying, and waking up at night to urinate. The study also found that the condition was not always just a nuisance; about 40 percent of the affected men experienced complications. The most common serious issue was acute urinary retention, a painful condition where a person cannot urinate at all, which often requires emergency medical intervention. Other complications included urinary tract infections and kidney problems.
When the researchers analyzed the data to find what made some men more likely to develop these symptoms than others, they identified several clear patterns. Age remained the strongest factor, with older men facing much higher odds of the condition. Beyond age, the study found that men who chewed khat were nearly three times more likely to have symptomatic prostate enlargement compared to those who did not. Having diabetes or kidney disease also significantly increased the risk, with men suffering from these conditions being several times more likely to experience symptoms. Perhaps the most powerful predictor was family history. Men who had a close relative with the condition were almost ten times more likely to develop it themselves. The study did not find strong links between the condition and factors like smoking, alcohol use, or income levels in this specific group.
These findings suggest that in the Benishangul-Gumuz region, symptomatic prostate enlargement is a common and often serious health issue for older men. The high rate of complications indicates that many men may be seeking help only after the condition has progressed. The strong connection to family history suggests that genetics play a major role, while the links to khat chewing, diabetes, and kidney disease point to specific lifestyle and health factors that doctors should consider when evaluating patients. The researchers concluded that identifying men with these risk factors early could help prevent severe complications. By paying closer attention to older men, those with a family history of the problem, and those who chew khat or have diabetes, healthcare providers in the region could potentially detect the condition sooner and manage it before it leads to emergency situations.
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