​What kinds of symptoms do patients experience before receiving treatment?

The primary condition treated with this surgery is benign overgrowth of the prostate, called benign prostatic hyperplasia (BPH). Patients generally present with urinary symptoms, including difficulty or inability to pass urine, urination frequency, passing very small amounts of urine, or passing urine very slowly. Some patients experience pain when trying to pass urine.

​What is the impact on patients’ lives of living with these conditions?

Most Malawians live in rural areas, and a large percentage of them work as farmers. This is also true of our medical partner's patient population. When men are experiencing symptoms related to BPH, they often have a hard time working on their farms. They are therefore unable to support themselves and their families. Before receiving surgery, many men will have a catheter placed, which can be uncomfortable and embarrassing. Additionally, using a catheter for a prolonged period of time can lead to infection or trauma to the area.

What cultural or regional factors affect the treatment of these conditions?

Although experiencing symptoms associated with BPH is not commonly viewed as taboo within our medical partner's patient population, it is rarely discussed. Men can feel embarrassment about the condition and the impact it has on their lives. Some men experience psychological effects from the condition.

What does the treatment process look like?

The standard treatment is a prostate resection, which is a fairly standard procedure. After the surgery, the patient will use a catheter for 14 days. Once the catheter is removed and the patient can pass urine freely, they can be discharged.

What is the impact of this treatment on the patient’s life?

If the treatment goes smoothly, it is expected that healthy patients will make a full recovery and not relapse.

What potential side effects or risks come with this treatment?

Although there are risks associated with any surgical procedure, the risks associated with a prostate resection are very low. However, as the patient population tends to be of older age, it is common that patients have other underlying conditions, such as high blood pressure. Patients who are candidates for this surgery are screened and monitored carefully. If a patient is found to have another health condition that could jeopardize their health during or after the surgery, that condition is addressed first.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

In the area of our medical partner's treatment center, there is one central, public hospital. That hospital provides surgical services, but barriers exist. A patient requiring a hernia repair could be on a waitlist for years at the central hospital, or be sent home and told to return a number of times. For this reason, treatment can be very difficult to obtain at the public hospital. In addition to our medical partner's treatment center and the central hospital, there are private clinics that would provide this service, but at a high fee. Our medical partner's treatment center, Nkhoma, is a great option for patients because they are able to receive quality treatment.

What are the alternatives to this treatment?

Drugs can be used to relieve symptoms for a short period of time, but ultimately, surgery is the only treatment.