Benign prostatic hyperplasia and lower urinary tract symptoms are quite prevalent in men with advancing age [4]. Clinical BPH may not be life threatening; however, its manifestation as LUTS interferes with QoL [12]. In this study, the mean age of participants was 64.2 ± 9.0 years with a range of 40 to 95 years. This is similar to 64.4 ± 8.9 years found in the study done by Badmus et al. [13] in Ife, South-Western Nigeria. Other similar findings were seen in [7, 14, 15]. The peak age group was 60–69 years consistent with the studies done by Movsas et al. [3] and Udeh et al. [15]. This findings further support the fact that BPH is a disease of men with advancing age [4]. Majority of the patients in this study were civil servants 94 (32.4%) with tertiary level of education. This was in contrast with the finding by Udeh et al. [15] in which majority of patients (61.0%) were farmers. This observation might be attributed to the fact that there are many higher institutions of learning in the study environment.
The mean IPSS value in this study was 16.3 ± 7.1 which was slightly different from the findings by Kenneth et al. [16] in Ghana and Ofoha et al. in Jos, Nigeria [17]. This difference may be due to a relatively larger sample size in this study when compared with their own studies with sample size of 225 and 103 patients, respectively. Another reason could be due to delay in seeking treatment in our environment as majority of the patients present with moderate and severe LUTS.
The mean prostate volume was found to be similar to those obtained by Mohammed et al. [18] in Zaria, North-Western Nigeria, and Badmus et al. [13] in Ife, South-Western Nigeria. A different value was obtained by Gnyawali et al. [19] in Kathmandu, Nepal, though they use transabdominal ultrasound scan to calculate the prostate volume in their study.
The correlation of prostate volume with the International Prostate Symptoms Score (IPSS) was found to be significant in this study (p = 0.002). Several studies were done to determine relationship between the prostate volume and severity of LUTS as measured by the IPSS, with various outcomes. A study done by Ofoha et al. [17] in Jos, North-Central Nigeria, reported a positive insignificant correlation between the prostate volume and IPSS. Similar findings of insignificant correlation between prostate volume and IPSS were also seen in other studies [7, 20, 21]. Some studies showed no relationship between prostate volume and IPSS [11, 22, 23], while some showed strong correlation [9, 10]. When the Qmax was correlated with the prostate volume, there was a negative significant correlation (p = 0.003). This showed an inverse relationship between the prostate volume and the maximum flow rate, i.e., as the prostate volume increases, the maximum flow rate decreases.
The most common LUTS was found to be nocturia in 282 patients (97.2%) followed by frequency in 258 patients (89.0%) which was consistent with the finding by Oranusi et al. [24] Majority of the patients in this study described nocturia as the most bothersome LUTS affecting their QoL. Like other studies, the storage (irritative) symptoms were more frequent among the patients than the voiding (obstructive) symptoms [4].
Quality of life assessment showed that 150 patients (51.7%) and 42 patients (14.5%) were unhappy (QoL = 5) and mostly dissatisfied (QoL = 4), respectively. This demonstrated that lower urinary tract symptoms in patients with benign prostatic hyperplasia significantly affect the quality of life. There was statistically significant relationship between the severity of LUTS assessed by IPSS and the QoL. This finding is consistent with the study by Patrick et al. [12] who concluded that it might be better to use the quality of life (QoL) as determinant of the choice of treatment, rather than the IPSS scores alone for prompt treatment of LUTS. Patients presented more with moderate IPSS symptoms (55.2%), mild symptoms (11.4%) and severe symptoms (33.4%), with the findings similar to that of Ofoha et al. [17]. Generally, our patients present late with moderate or severe LUTS probably because in many cases, mild symptoms are accepted as a natural occurrence with aging, and men learn to live with them. The level of education has no influence on presentation in this study, because majority still present with moderate and severe symptoms on IPSS despite having tertiary level of education. The limitation of the study includes problems with administration of International Prostate Symptoms Score questionnaire in those without formal education that require interpretation and or administration by the researcher, which may result in some level of bias in the ultimate IPSS score.