Clinical characteristics of african men with Prostate diseases in a tertiary centre in western Kenya

Abstract

Background: Prostate diseases are a common problem worldwide. This study was aimed at o establishing the clinical characteristics of patients diagnosed to have prostate diseases in the Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya. Methods: This was a cross-sectional, hospital based, descriptive study undertaken in the Urology Outpatient Clinic and Surgical Ward of MTRH. A total of 219 patients aged 50 years and above with prostate diseases were recruited into an Institutional Research and Ethics Committee (IREC) approved study after granting a formal consent. The primary outcome measure was the clinical characteristics of patients with acute prostatitis, Benign Prostate Hyperplasia (BPH) and Prostate Cancer in MTRH. The secondary outcome measures were the demographic data and co morbidities. Results: Patients’ ages ranged from 50 to 96 years with a mean of 65.4 s.d. ± 10.2 years. The majority (68%) of them presented with a past history of urinary retention; 71.7% had palpably enlarged prostate on DRE. The annual incidence of prostate diseases in the Urology Clinic was 31.1% with the prevalence of Acute Prostatitis, BPH and Prostate Cancer being 1.8%, 63.9% and 34.3% respectively. Only 28.3% of the patients had PSA levels in the laboratory normal range of 0-4ng/ml. There was a 32.4% surgical rate in the care of these patients with Trans-Urethral Resection of the Prostate (TURP) accounting for 57.8% of the surgeries and 68.3% of the operations on the prostate. Conclusion: Benign Prostate Hyperplasia (BPH) is the leading clinical pathology in indigenous black African patients presenting with prostate diseases in MTRH despite high PSA levels. Majority of these patients have enlarged prostates and history of urine retention. Recommendations: The standard approaches of clinical assessment and PSA are wanting in many aspects and the Caucasian studies may not truly reflect on indigenous black Africans. It is recommended that this be borne in mind as diagnoses of the various prostate diseases are made.