AN ANALYTICAL STUDY OF THERAPEUTIC OUTCOMES IN THE MEDICAL AND SURGICAL MANAGEMENT OF PROSTATE ENLARGEMENT

Abstract

Benign Prostatic Hyperplasia (BPH) is a common urological condition in aging males, yet there remains insufficient comparative evidence on the effectiveness of medical versus surgical management in improving long-term therapeutic outcomes within Pakistani tertiary healthcare settings. This gap is particularly significant in resource-constrained environments where treatment decisions are often influenced by patient load, cost considerations, and variable follow-up systems. This study is grounded in the Biopsychosocial Model, which explains disease outcomes through the interaction of biological progression of prostate enlargement, psychological distress caused by urinary symptoms, and social limitations affecting daily functioning and quality of life. It provides a holistic framework for understanding how symptom severity translates into reduced productivity, sleep disturbance, and decreased overall well-being. A retrospective quantitative comparative design was adopted using patient records from major Lahore-based hospitals, including Sheikh Zayed Hospital Lahore, Mayo Hospital Lahore, Services Hospital Lahore, and Jinnah Hospital Lahore. A total dataset of 200 patients (100 receiving medical therapy and 100 undergoing TURP surgery) from 2022–2025 was analyzed. Patients were followed through documented clinical visits to assess progression and treatment response under standardized urological protocols. Outcome measures included International Prostate Symptom Score (IPSS), post-void residual (PVR) urine volume, and peak urinary flow rate (Qmax). Surgical management showed greater clinical improvement, with a mean IPSS reduction of 15.6 compared to 8.9 in the medical group. PVR decreased by 67% in surgical patients versus 41% in medically treated patients. Qmax improvement and quality-of-life scores were also significantly higher in the surgical group, indicating more sustained functional recovery. IPSS reduction, PVR reduction, Qmax improvement, catheter dependency rate, hospitalization duration, and quality-of-life index were used as measurable outcomes to ensure objective evaluation of therapeutic efficacy.