Does intraprostatic inflammation have a role in the pathogenesis and progression of benign prostatic hyperplasia?
OBJECTIVE
To compare the incidence of acute and/or chronic intraprostatic inflammation (ACI) in men undergoing transurethral resection of the prostate (TURP) for urinary retention and lower urinary tract symptoms (LUTS), as recently a role was suggested for ACI in the pathogenesis and progression of BPH, and urinary retention is considered an endpoint in the natural history of this condition.


METHODS
Details of TURPs done between January 2003 and December 2005 at one institution were obtained from the operating theatre database. Patients were divided by indication (retention/LUTS). Clinical data and histology reports were then reviewed and bivariate and logistic regression used to compare the pathological features between these groups.


RESULTS
Of 406 patients, 374 had evaluable data; 70% of men with urinary retention had ACI, vs 45% of those with LUTS (P < 0.001). On logistic regression, the pathological factors associated with TURP for acute retention compared to that for LUTS were ACI, old age, and resection weight to a lesser degree.


CONCLUSIONS
Inflammation appears to be important in the pathogenesis and progression of BPH. In this study, the risk of urinary retention due to BPH was significantly greater in men with ACI than in those without, and the association of TURP for retention with ACI was stronger than that with prostate weight. This finding might offer new avenues for the medical treatment of men with LUTS due to BPH.
Mishra
Vibhash C
VC
Department of Urology, Wexham Park Hospital, Slough, UK. vibhashmishra@gmail.com
Allen
Darrell J
DJ
Nicolaou
Christophoros
C
Sharif
Haytham
H
Hudd
Charles
C
Karim
Omer M A
OM
Motiwala
Hanif G
HG
Laniado
Marc E
ME
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D018450:Disease Progression; D006801:Humans; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000150:complications* / Q000601:surgery; D053448:Prostatism / Q000209:etiology* / Q000601:surgery; D011472:Prostatitis / Q000150:complications* / Q000601:surgery; D012044:Regression Analysis; D012189:Retrospective Studies; D020728:Transurethral Resection of Prostate; D016055:Urinary Retention / Q000209:etiology* / Q000601:surgery