title: Effects of prostatic inflammation on LUTS and alpha blocker treatment outcomes.
abstract: OBJECTIVE
  To evaluate the association between prostatic inflammation and lower urinary tract symptoms (LUTS), and to identify the effects of prostatic inflammation on the treatment with an alpha blocker.
  
  
  METHODS
  111 Participants who were aged ≥ 50 years, the presence of LUTS (maximal flow rate < 20 m/s, IPSS ≥ 11), and an elevated PSA level (3-20 ng/mL) were treated with tamsulosin 0.2mg once daily for 3 months after prostate biopsies. Prostatic inflammation was scored as none (0), mild (I), moderate (II), or marked (III). LUTS parameters including urine flow rates, IPSS, PSA, and prostate volume were evaluated.
  
  
  RESULTS
  Inflammation grading resulted in 25, 60, and 26 patients that were grade 0, I, and II, respectively. Lower grade inflammation was related to higher urine flow rate at baseline. Patients with higher inflammation grades had larger prostate volumes, larger total and transitional zone volumes, and higher PSA levels. Overall, urine flow rates and residual urine volume were improved after 3 months of alpha blocker therapy. Eighty percent of patients with grade 0 inflammation, 73% of patients with grade I inflammation, and 92.3% of patients with grade II inflammation showed improvement of LUTS after treatment. Longer duration of treatment was related to a decreased chance of improvement of LUTS. Patients with increased IPSS voiding subscales could be predictive of improvement of LUTS.
  
  
  CONCLUSIONS
  Patients with high grade inflammation had lower flow rates and higher prostatic volumes than patients with low grade inflammation. Inflammation grade did not affect the outcomes of alpha blocker treatment.
authors.affiliation: Department of Urology, Ewha Womans University Medical Center Seoul Seonam Hospital, Seoul, Korea.
authors.forename: Ha Na
authors.initials: HN
authors.lastname: Lee
authors.affiliation: Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul.
authors.forename: Tae-Hyoung
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Sun-Ju
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Dong-A University Hospital, Dong-A University School of Medicine, Busan, Seoul, Korea.
authors.forename: Won Yeol
authors.initials: WY
authors.lastname: Cho
authors.affiliation: Ewha Womans University Mok-dong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Bong Suk
authors.initials: BS
authors.lastname: Shim
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000368:Aged; D001706:Biopsy; D018450:Disease Progression; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000188:drug therapy* / Q000473:pathology; D011472:Prostatitis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D016896:Treatment Outcome
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D013449:Sulfonamides; D017430:Prostate-Specific Antigen; D000077409:Tamsulosin