Benign Hypertrophy of the Prostate (BPH), also known as benign prostatic hyperplasia, is a common condition among aging men, characterized by the non-cancerous enlargement of the prostate gland. This condition often leads to a variety of urinary symptoms, affecting the quality of life of affected individuals [1,2]. While BPH is a prevalent condition, it is often under diagnosed and underreported, particularly in rural and remote areas such as Manali, Himachal Pradesh. 

BPH is a progressive condition and its prevalence increases with age. By the age of 60, a significant percentage of men may exhibit symptoms related to BPH and this prevalence further rises with advancing age. The symptoms of BPH can range from mild urinary discomfort to severe lower urinary tract symptoms (LUTS), including urinary frequency, urgency, nocturia, weak stream and incomplete bladder emptying. These symptoms can significantly impact an individual's quality of life, leading to sleep disturbances, reduced work productivity and psychological distress [3-6].

Early diagnosis and appropriate management of BPH are crucial to alleviate these symptoms and prevent complications such as acute urinary retention and the need for surgical intervention. However, in many instances, a lack of awareness among patients regarding BPH, its symptoms and available treatment options may result in delayed diagnosis and unnecessary suffering [6,7].

The state of Himachal Pradesh, known for its picturesque landscapes and cultural diversity, faces unique healthcare challenges, especially in remote areas like Manali. The population in such regions may have limited access to healthcare facilities and may be less informed about health conditions such as BPH. The aim of this study is to assess the level of awareness among male patients visiting the outpatient department of Civil Hospital in Manali. By understanding the existing knowledge and perceptions of BPH in this specific population, we can develop strategies to enhance awareness, early detection and prompt management.

To our knowledge, there is limited research on the awareness of BPH and its management in rural Himachal Pradesh. This study will contribute valuable insights that could help healthcare providers and policymakers develop tailored educational programs, increase early diagnosis rates and improve the quality of life for patients affected by BPH in this region.

This study aims to bridge the knowledge gap regarding BPH and its implications in the male population attending the outpatient department of Civil Hospital, Manali, District Kullu, Himachal Pradesh. By addressing this gap, we hope to facilitate earlier diagnosis, promote informed decision-making and ultimately enhance the quality of life for those affected by BPH in this region.

Objectives of the Study

To evaluate the awareness about Benign Hypertrophy of Prostate (BPH) among male patients attending outpatient department of Civil Hospital, Manali, District Kullu, Himachal Pradesh.

• Research Approach: Descriptive

• Research Design: Hospital based cross-sectional survey design

• Setting of the Study: OPD in Civil Hospital, Manali, District Kullu Himachal Pradesh

• Study Duration: Between July 2023- September 2023

• Study Population: Male patients aged above 30 years came to OPD 

• Sample Size: 400 male patients, assuming 50% have adequate knowledge regarding Benign Hypertrophy of Prostate (BPH), 5% absolute error, 95% confidence level and 5% non-response rate

• Sampling Technique: Convenience Sampling technique

• Sampling Criteria: First five male patients who came to OPD were selected everyday till the completion of sample size after explaining the purpose of the study. Informed consent was taken from them and confidentiality of the selected participants was also maintained 

• Inclusive Criteria: Male patients who were willing to participate in the study

• Exclusion Criteria: Male patients who were not willing to participate in the study

Description of Tool

• Demographic Data Survey Instrument: The demographic form elicited information on participants’ background: age, marital status, religion, employment, education, family’s monthly income etc.

• Questionnaire: The questionnaire contains 20 structured knowledge related questions having three options (yes, no, don’t know). The participants have to choose right one. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero. Scoring was done on the basis of marks as >80% (16-20) = very good, 60-79% (12-15) = Good, 41-59% (8-11) = Fair, <40% (<8) = poor

• Validity of Tool: By the experts in this field

• Data collection by under the guidance of supervisors and patients were given 30 minutes’ time to complete that questionnaire and collected at the end of the prescribed time

• Data analysis with Epi Info V7 Software with appropriate statistical test in terms of frequencies, percentage

The goal of the current study was to assess the awareness about Hypertrophy of Prostate (BPH) among male patients attending outpatient department of Civil Hospital, Manali, District Kullu, Himachal Pradesh.

A total of 400 male respondents including 149 (37.25%) were from urban area and 251(632.75%) were from rural area were participated in the study (Table 1).

In the present study 17% (68) participants had very good knowledge (16-20 marks) towards Benign Hypertrophy of Prostate (BPH), 25.25% (101) had good knowledge (12-15 marks), 24.25% (97) had fair knowledge (8-11 marks) and 33.5% (134) having poor knowledge (<8 marks) (Table 2).

Table 1: Knowledge Regarding Benign Hypertrophy of Prostate (BPH) among Study Participants

Table 2: Knowledge Score Regarding Benign Hypertrophy of Prostate (BPH) among Study Participants

The findings of this study provide valuable insights into the awareness of Benign Hypertrophy of the Prostate (BPH) among male patients attending the outpatient department of Civil Hospital in Manali, District Kullu, Himachal Pradesh. The results indicate a range of knowledge levels among the participants, highlighting the need for targeted educational efforts and interventions in this region.

The majority of participants in this study were from rural areas, which is significant given the unique healthcare challenges faced by remote and rural populations. It is notable that 50.75% of the respondents correctly identified BPH and its definition and a similar percentage recognized common symptoms associated with BPH. This is indicative of a moderate level of awareness in the population, but there is room for improvement.

In contrast, a lower proportion of respondents (41.5%) were aware of how BPH is diagnosed, suggesting a gap in knowledge regarding diagnostic methods. Early diagnosis is crucial for timely management and the prevention of complications. Therefore, efforts should be made to educate the community about the diagnostic procedures available for BPH.

The knowledge level regarding treatment options for BPH (47.25%) also needs enhancement. It is essential for patients to be informed about the various therapeutic approaches, including lifestyle modifications, medications and surgical interventions, to make well-informed decisions regarding their healthcare.

Furthermore, the study revealed that 49.5% of participants recognized the existence of medications specifically prescribed for BPH and 50.25% were aware of situations in which surgical intervention might be necessary. These findings demonstrate a reasonably good understanding of treatment modalities and the potential need for medical or surgical management.

Moreover, 48.5% of the respondents acknowledged the role of lifestyle changes in managing BPH symptoms. This underscores the importance of education on lifestyle modifications, which can significantly improve the quality of life for individuals with BPH.

However, areas that require more attention include the knowledge regarding the risk factors associated with BPH (49.25%) and the potential complications of untreated BPH (49.75%). These aspects are crucial for promoting preventive measures and early intervention.

Interestingly, the study found that 46.5% of participants were aware that BPH could be mistaken for prostate cancer, indicating some confusion between the two conditions. This suggests the need for clearer information and education differentiating BPH from prostate cancer.

While 44.75% of the participants correctly identified that BPH is not a curable condition, this highlights the necessity of promoting realistic expectations and long-term management strategies.

This study's findings are consistent with the notion that the awareness of BPH and its management can vary among different populations and regions. The results of this study align with those of previous research, emphasizing the need for ongoing educational initiatives and awareness campaigns to bridge the knowledge gap regarding BPH, especially in rural and remote areas like Manali, Himachal Pradesh [7-11].

To address the observed knowledge gaps, healthcare providers and policymakers should consider developing community-specific educational programs and campaigns to improve awareness and understanding of BPH. Additionally, efforts to increase accessibility to healthcare services and facilitate early diagnosis and management should be a priority.

In conclusion, this study has shed light on the awareness of BPH among male patients in Manali, Himachal Pradesh. While there is a moderate level of awareness in some areas, such as BPH definition and symptoms, there are knowledge gaps in diagnostic procedures, risk factors and complications. These findings should serve as a foundation for designing and implementing targeted interventions to enhance awareness, promote early diagnosis and ultimately improve the quality of life for individuals affected by BPH in this region.

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