Sexual dysfunction in patients undergoing non-surgical management of benign prostatic enlargement at Kenyatta national hospital.

Abstract

Background: Sexual dysfunction is a major complaint of patients with benign prostatic enlargement undergoing treatment at Kenyatta National Hospital (KNH). This could result from the primary pathology, various pharmacological agents used for treatment of the same, age, severity of lower urinary tract symptoms or various unknown factors. Study Objective: To determine the prevalence and associated factors of sexual dysfunction (SD) amongst patients undergoing treatment for benign prostatic enlargement (BPE) at the Kenyatta national hospital (KNH). Methodology: The study was a cross sectional study where 80 patients undergoing treatment for benign prostatic enlargement at the urology clinics were recruited. All patients enrolled in the study had their bio-data, history, clinical examination, and prostate specific antigen test and ultrasound findings recorded. A standard assessment of erectile dysfunction was done using the international index of erectile function score (IIEF) tool. Detailed history of the medication that was being used was taken and analyzed. Severity of lower urinary tract symptoms (LUTS) was assessed using the international prostatic symptom score (IPSS). Data collection was done using a pretested structured questionnaire and analyzed using IBM SPSS and presented in the form of bar graphs and tables. A P value of 0.05 and confidence interval of 95 % was used to determine significance of collected data. Study results: The study was conducted between May 2019–August 2019 Patients were recruited by consecutive random sampling until the sample size of 80 was achieved. The mean age of patients was 68 yrs. The prevalence of erectile dysfunction (ED) was 81%. 47.7% had severe ED, and 6.2% had moderate ED, 24.5% had mild to moderate ED while 21.5% had mild ED. 61% of patients had moderate lower urinary tract symptoms, while, 35 % had severe lower urinary tract symptoms. Only 4% had mild symptoms. 90% of the patients enrolled were on medication for BPH while the remaining 10% were not or had not been started on medication for BPH. 3% of the study population had diabetes mellitus, 38% had hypertension, while 13% had both diabetes mellitus and hypertension. Conclusion: This study demonstrated that Sexual dysfunction in BPE is associated with age, lower urinary tract symptoms, diabetes mellitus, hypertension and medication used in BPH while Prostate size and PSA levels were not associated with sexual dysfunction in BPH.