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An Z, Zhou Q, Shao J, Xiao S, Zhao K, Wei W, Wu Y, Song Y, Yuan Q, Fu W, Zhang X. Life disturbance and hospital visit experiences among Chinese patients with benign prostatic hyperplasia: a qualitative study. BMC PRIMARY CARE 2024; 25:149. [PMID: 38702603 PMCID: PMC11069269 DOI: 10.1186/s12875-024-02378-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/09/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND The impact of lower urinary tract symptoms (LUTS) on the quality of life of patients with benign prostatic hyperplasia (BPH) has been rarely reported. Additionally, the challenges faced by these patients in seeking medical care have often been overlooked. In order to explore the personal struggles caused by LUTS and the difficulties or barriers experienced by Chinese patients with BPH when seeking help, we conducted a qualitative interview study. METHODS Qualitative interviews were conducted among 46 patients with BPH who were hospitalized in three tertiary hospitals in China from July 2021 to November 2022. Grounded theory was adopted as the methodology for the qualitative study. After obtaining written informed consent from the study participants, semi-structured interviews were conducted according to the question guidelines. The interview process was audio-recorded; subsequently, the recordings were transcribed, coded, and thematically analyzed. RESULTS The difficulties faced by Chinese patients with BPH were classified into seven main themes: (i) disturbed life, (ii) mental burden, (iii) disease cognition and communication, (iv) delayed treatment, (v) medication status, (vi) hospital visits barriers, and (vii) medical insurance issues. Further, each theme was subdivided into 2-5 sub-themes. CONCLUSIONS LUTS have a certain effect on the life and spirit of patients with BPH. These patients face different degrees of difficulties in treatment and hospital visits. Therefore, better healthcare systems and additional social support are crucial for improving the current plight of these patients.
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Affiliation(s)
- ZiYan An
- Department of Urology, Third Medical Center, PLA General Hospital, YongDing Road No. 69, Beijing, 100039, China
- Medical School of PLA, Beijing, 100853, China
| | - QiWei Zhou
- Department of Urology, Third Affiliated Hospital of Naval Military Medical University, Shanghai, 200438, China
| | - JinPeng Shao
- Department of Urology, Third Medical Center, PLA General Hospital, YongDing Road No. 69, Beijing, 100039, China
- Medical School of PLA, Beijing, 100853, China
| | - ShuWei Xiao
- Department of Urology, Air Force Medical Center, Beijing, 100142, China
| | - Kun Zhao
- Department of Urology, Third Medical Center, PLA General Hospital, YongDing Road No. 69, Beijing, 100039, China
- Medical School of PLA, Beijing, 100853, China
| | - WenJie Wei
- Department of Urology, Third Medical Center, PLA General Hospital, YongDing Road No. 69, Beijing, 100039, China
- Medical School of PLA, Beijing, 100853, China
| | - YangYang Wu
- Department of Urology, Third Medical Center, PLA General Hospital, YongDing Road No. 69, Beijing, 100039, China
- Medical School of PLA, Beijing, 100853, China
| | - Yong Song
- Department of Urology, Third Medical Center, PLA General Hospital, YongDing Road No. 69, Beijing, 100039, China
| | - Qing Yuan
- Department of Urology, Third Medical Center, PLA General Hospital, YongDing Road No. 69, Beijing, 100039, China
| | - WeiJun Fu
- Department of Urology, Third Medical Center, PLA General Hospital, YongDing Road No. 69, Beijing, 100039, China.
| | - Xu Zhang
- Department of Urology, Third Medical Center, PLA General Hospital, YongDing Road No. 69, Beijing, 100039, China
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Groot Wesseldijk K, van Reemst HE, ter Horst E, Knol-de Vries GE, Blanker MH. Differences in help-seeking behaviour between males and females with multiple pelvic floor symptoms: A qualitative study. Heliyon 2024; 10:e29110. [PMID: 38601533 PMCID: PMC11004654 DOI: 10.1016/j.heliyon.2024.e29110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/14/2024] [Accepted: 04/01/2024] [Indexed: 04/12/2024] Open
Abstract
Background Pelvic floor symptoms (PFS) are common and frequently co-occur, but few patients seek help despite negative effects on their quality of life. Moreover, most studies assessing help-seeking behaviour have only focused on a single PFS. Aim We aimed to explore the barriers to and facilitators of help-seeking behaviour in males and females with at least two PFS. Design and Setting This interview-based study included participants by age and symptoms (number and type) from a larger group taking part in a survey on PFS in the general population. Method Two researchers independently encoded and analyzed the semi-structured interviews, which continued to saturation for both the male and female cohorts. Results Of the 25 participants (13 male and 12 female), 9 sought help for all PFS, 10 did not seek help for any PFS, and 6 sought help for some PFS. We identified themes in domains related to the patient, healthcare professional, environment, and symptoms. Although most themes applied to both sexes, some had greater sex specificity. Conclusion Males and females have more similarities than differences in help-seeking behaviour. Healthcare providers should know that patients who seek help for one symptom probably have multiple PFS that the patient has not reported.
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Affiliation(s)
- Kim Groot Wesseldijk
- Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Hannah E. van Reemst
- Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Ellen ter Horst
- Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Grietje E. Knol-de Vries
- Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Marco H. Blanker
- Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Kaltsas A, Kratiras Z, Zachariou A, Dimitriadis F, Sofikitis N, Chrisofos M. Evaluating the Impact of Benign Prostatic Hyperplasia Surgical Treatments on Sexual Health. Biomedicines 2024; 12:110. [PMID: 38255215 PMCID: PMC10813562 DOI: 10.3390/biomedicines12010110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 12/30/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
Benign prostatic hyperplasia (BPH), a prevalent condition in older men, is often managed through various surgical interventions. This narrative review aims to explore the impact of these surgical treatments on sexual function, a critical aspect of patient quality of life often overlooked in BPH management. The methodology encompassed a thorough review of contemporary surgical techniques for BPH, including prostate resection, enucleation, vaporization, and minimally invasive therapies such as UroLift, Rezum, and Aquablation. Additionally, the focus was on patient-centered outcomes, with a special emphasis on sexual health following surgery. Findings reveal that, while surgical interventions effectively alleviate BPH symptoms, they often have significant repercussions in sexual function, including erectile and ejaculatory dysfunction. However, emerging techniques demonstrate potential in preserving sexual function, underscoring the need for patient-centric treatment approaches. The study highlights the complex interplay between BPH surgery and sexual health, with minimally invasive treatments showing promise in balancing symptom relief and sexual function preservation. In conclusion, the study advocates for an integrated, interdisciplinary approach to BPH treatment, emphasizing the importance of considering sexual health in therapeutic decision-making. This narrative review suggests a paradigm shift towards minimally invasive techniques could optimize patient outcomes, marrying symptom relief with quality-of-life considerations. The need for further research in this domain is evident, particularly in understanding long-term sexual health outcomes following different surgical interventions for BPH.
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Affiliation(s)
- Aris Kaltsas
- Third Department of Urology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece; (A.K.); (Z.K.)
| | - Zisis Kratiras
- Third Department of Urology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece; (A.K.); (Z.K.)
| | - Athanasios Zachariou
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.Z.); (N.S.)
| | - Fotios Dimitriadis
- Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Nikolaos Sofikitis
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.Z.); (N.S.)
| | - Michael Chrisofos
- Third Department of Urology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece; (A.K.); (Z.K.)
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Zhang Y, Hou S, Qi Z, Wu S, Zhu K, Wang W. Non-pharmacological and nonsurgical interventions in male urinary incontinence: A scoping review. J Clin Nurs 2023; 32:6196-6211. [PMID: 37161602 DOI: 10.1111/jocn.16749] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/10/2023] [Accepted: 04/25/2023] [Indexed: 05/11/2023]
Abstract
AIMS To describe and synthesize non-pharmacological and nonsurgical interventions for male urinary incontinence from the existing literature. METHODS A scoping review was conducted following the methodology suggested by Arksey and O'Malley: (1) identification of the research questions; (2) identification of relevant studies using a three-step search recommended by JBI: an initial search within PubMed and CINAHL, a comprehensive literature search within PubMed, CINAHL, EMBASE, PsycINFO, Cochrane Library, and literature search of references lists; (3) study selection; (4) data extraction and charting; (5) collation, summarization, and reporting of the results. The PRISMA-ScR Checklist was used to report. RESULTS A total of 4602 studies were identified, of which 87 studies were included. Approximately 78% were randomized controlled trials. More than 88% of the participants were men with prostate cancer. Exercising pelvic floor muscles 30 times per day for 12 weeks was the most frequently reported. Parameters of electrical stimulation were typically set up to 50 Hz and 300 μs for frequency and width of pulse, respectively, and lasted for 15 min. Pure pelvic floor muscle training, Pilates, Yoga, whole body vibration, diaphragm/abdominal muscle training, micturition interruption exercise, acupuncture, and auriculotherapy showed positive effects on reducing urinary incontinence. CONCLUSION The findings suggested implementing pelvic floor muscle training alone before or after surgery can both prompt the recovery of continence in men after prostate cancer surgery. The decision to use biofeedback or electrical stimulation to enhance the therapeutic effect of pelvic floor muscle training should be approached with caution. More rigorous designed studies are needed to validate the effectiveness of Traditional Chinese Medicine techniques and diverse novel methods. RELEVANCE TO CLINICAL PRACTICE Physicians and nurses need to be up to date on the latest evidence-based non-pharmacological and nonsurgical interventions in male urinary incontinence and select appropriate interventions based on available medical resources and patient preferences.
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Affiliation(s)
- Ying Zhang
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
- Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
| | - Sijia Hou
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
- Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
| | - Ziyi Qi
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
- Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
| | - Siyuan Wu
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
- Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
| | - Keping Zhu
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
| | - Wei Wang
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China
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Ugwumba FO, Nnabugwu II. Prostate cancer characteristics: A descriptive analysis of clinical features at presentation in the last decade in a black African community. Ann Afr Med 2022; 21:153-157. [PMID: 35848648 PMCID: PMC9383014 DOI: 10.4103/aam.aam_101_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
Background: Prostate cancer, previously reported as relatively rare in Nigeria, is currently the leading cancer and leading cause of cancer-related death in men. Late presentation appears to persist despite higher incidence rates and instituted awareness programs. This study assesses current prostate cancer indices at presentation to a 3rd tier referral hospital in South-east Nigeria and compares these indices with reported indices from previous decades. Materials and Methods: Retrospectively, the medical records of men presenting with histologically confirmed prostate cancer from January 2009 to April 2018 were reviewed. Age, spectrum and duration of clinical features, serum total prostate-specific antigen (tPSA), and prostate biopsy specimen Gleason Score (GS) at presentation were retrieved for the analysis using the SPSS software version 21. Obtained mean values and proportions were compared to reports from previous decades for observable shifts. Results: The medical records of 331 men 51–90 years of age (mean: 69.8 ± 8.0 years) were retrieved. Six (1.8%) men (median tPSA = 28.0 ng/ml; range 10.0–121.4 ng/ml) had screening-detected prostate cancer. About 72.0%, 52.0%, and 30.3% of men present with symptoms after 3 months, 6 months, and 12 months, respectively, and about 55.1% had other clinical features of disease progression beyond lower urinary tract symptoms. Symptom duration, serum tPSA (median 31.4 ng/ml; range 4.0–710.0 ng/ml), and % fPSA (median 20.6%; range 57.1%–8.6%) at presentation, as well as prevalent poorly-differentiated tumor (GS ≥7 [4 + 3] 62.2%) are yet to shift from reports from previous decades. Conclusions: Prostate cancer indices at presentation in South-eastern Nigeria, a resource-poor community in sub-Saharan Africa are yet to positively shift despite efforts at prostate cancer awareness.
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Affiliation(s)
- Fredrick O Ugwumba
- Faculty of Medical Sciences, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Ikenna I Nnabugwu
- Department of Surgery, Urology Unit, University of Nigeria Teaching Hospital, Enugu, Nigeria
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Managing lower urinary tract symptoms in primary care: qualitative study of GPs' and patients' experiences. Br J Gen Pract 2021; 71:e685-e692. [PMID: 34097640 PMCID: PMC8340731 DOI: 10.3399/bjgp.2020.1043] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/13/2021] [Indexed: 11/25/2022] Open
Abstract
Background Lower urinary tract symptoms (LUTS) are common in males aged ≥40 years and have a considerable impact on quality of life. Management can be complex, and although most LUTS could be treated effectively in primary care, referrals to urology outpatients are increasing. Aim To explore GPs’ experiences of managing LUTS together with patients’ experiences of and preferences for treatment in primary care. Design and setting Telephone interviews were conducted with GPs and male patients presenting to primary care with bothersome LUTS. Method Eleven GPs and 25 male patients were purposively sampled from 20 GP practices in three UK regions: Newcastle upon Tyne, Bristol, and South Wales. Interviews were conducted between May 2018 and January 2019, and were analysed using a framework approach. Results Difficulty establishing causes and differentiating between prostate and bladder symptoms were key challenges to the diagnosis of LUTS in primary care, often making treatment a process of trial and error. Pharmacological treatments were commonly ineffective and often caused side effects. Despite this, patients were generally satisfied with GP consultations and expressed a preference for treatment in primary care. Conclusion Managing LUTS in primary care is a more accessible option for patients. Given the challenges of LUTS diagnosis, an effective diagnostic tool for use by GPs would be beneficial. Ensuring bothersome LUTS are not dismissed as a normal part of ageing is essential in improving patients’ quality of life. Greater exploration of the role of non-pharmacological treatments is needed.
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