title: Does intraprostatic inflammation have a role in the pathogenesis and progression of benign prostatic hyperplasia?
abstract: 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.
authors.affiliation: Department of Urology, Wexham Park Hospital, Slough, UK. vibhashmishra@gmail.com
authors.forename: Vibhash C
authors.initials: VC
authors.lastname: Mishra
authors.forename: Darrell J
authors.initials: DJ
authors.lastname: Allen
authors.forename: Christophoros
authors.initials: C
authors.lastname: Nicolaou
authors.forename: Haytham
authors.initials: H
authors.lastname: Sharif
authors.forename: Charles
authors.initials: C
authors.lastname: Hudd
authors.forename: Omer M A
authors.initials: OM
authors.lastname: Karim
authors.forename: Hanif G
authors.initials: HG
authors.lastname: Motiwala
authors.forename: Marc E
authors.initials: ME
authors.lastname: Laniado
mesh_terms: 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