Date of Award


Document Type


Degree Name

Master of Medicine (MMed)

First Supervisor/Advisor

Dr. Jacob Shabani

Second Supervisor/Advisor

Dr. Jasmit Shah

Third Supervisor/Advisor

Dr. Njeri Nyanja


Family Medicine (East Africa)


Background: There is a relationship between Benign Prostatic Enlargement (BPE) and Lower Urinary Tract Symptoms (LUTS). The persistence of LUTS can negatively affect the quality of living by interrupting daily activities. Depressive symptoms occur commonly in patients with BPE. Depression is a taboo subject in Africa, and Kenya is no exception. Depression at its worst can lead to suicide. Thus, it is of great importance to recognise the factors associated with depressive symptoms in patients with BPE and hence reinforce the need to assess depression in patients with BPE in our clinical practice.

Objective: This study sought to determine the prevalence of depression in patients diagnosed with BPE. The study also wanted to establish factors associated with depressive symptoms in patients diagnosed with BPE and determine the correlation between the severity of LUTS and depression.

Methods: A cross-sectional design was implemented in the collection of data. The paper focused on 308 male individuals who are 40 years and beyond. Study subjects attended the urology clinic and family medicine clinic (FMC) in Aga Khan University Hospital Nairobi and the urology clinic in Aga Khan Hospital Mombasa. An interviewer-administered questionnaire was used in the collection of data. Depression was analysed using Patient Health Questionnaire- 9 (PHQ-9) while BPE was assessed using International Prostate Symptom Score (IPSS). The prevalence of depression and categorical independent variables were determined through the use of frequency and percentage. Continuous data was estimated through the use of median and interquartile ranges. Logistic regression was applied in the assessment of the relationships between depressive symptoms and independent variables at the bivariate level. Fisher’s Exact test was utilised to compare the degree of depressive symptoms among BPE patients. The level of statistical significance was set at p<0.05.

Results: Prevalence of depression among patients with BPE was found to be 2.90% while those with depressive symptoms was 42.90%. Logistic regression analysis showed that comorbid conditions, medication side effects, sexual problems (especially reduced libido) and fear in regards to the prostate condition were statistically importantly associated with symptoms of depression in patients with BPE. Depression was found to be correlated with LUTS severity [Co-relation co-efficient Spearman’s = 0.0326 (p-value <0.001)].

Conclusion: High frequency of depressive symptoms were found among men with symptomatic BPE. Assessment and early intervention of depressive symptoms among men with BPE should be initiated before clinical depression sets in. This is because depression is associated with high morbidity and mortality.