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What ' s known on the subject? and What does the study add? It is known that histological prostatitis is associated with a signifi cantly higher risk for acute urinary retention in men with BPH. This study showed that, in men with BPH, histological prostatitis was associated with urinary retention at a signifi cantly younger age and with higher serum PSA levels. In men with ACP, histological prostatitis was associated with urinary retention at an earlier stage of cancer. Study Type -Prognosis (individual cohort) Level of Evidence 2b OBJECTIVE• To compare the clinical features of patients having urinary retention and benign prostatic hyperplasia (BPH) with those having adenocarcinoma of the prostate (ACP) and to evaluate the signifi cance of histological prostatitis. PATIENTS AND METHODS• The clinical data and histopathology reports of patients with retention admitted to Tygerberg Hospital between September 1998 and June 2007 were evaluated.• Statistical analysis was performed with Student ' s t -test, Mann -Whitney test and Fisher ' s exact test where appropriate and P < 0.05 was considered to indicate statistical signifi cance. RESULTS• Prostatic histology was available in 405 patients, 204 with BPH and 201 with ACP.• Comparing those with BPH and those with ACP showed statistically signifi cant differences in mean age (69.5 vs 71.9 years), serum prostate-specifi c antigen (PSA) level (18.6 vs 899.5 ng/mL) and histological prostatitis (48 vs 25%) but not duration of catheterization, prostate volume or urinary tract infection (UTI).• Comparing those with BPH only and those with BPH plus prostatitis showed signifi cant differences in mean age (71.9 vs 67.1 year) and PSA level (14.6 vs 22.8 ng/ mL) but not prostate volume, UTI or duration of catheterization.• Comparing those with ACP only and those with ACP plus prostatitis showed signifi cant differences in stage T4 cancer (68.1 vs 35.4%) and PSA level (1123.4 vs 232.4 ng/mL) but not age, prostate volume, UTI or duration of catheterization. CONCLUSIONS• Histological prostatitis was almost twice as common in patients with urinary retention associated with underlying BPH than in patients with ACP, but there was no signifi cant difference in the duration of catheterization, prostatic volume or presence of UTI, suggesting that histological prostatitis more often contributes to the development of retention in patients with underlying BPH than in those with ACP.• In patients with BPH, histological prostatitis was associated with urinary retention at a signifi cantly younger age and with higher serum PSA levels.• In patients with ACP, histological prostatitis was associated with urinary retention at an earlier stage of cancer. A recent meta-analysis found a signifi cant association between prostatitis and ACP among population-based, case -control studies [ 4 ] . However, it is not clear whether there is an association between prostatic infl ammation and urinary retention in patients with ACP. KEYWORDSThe aims of the present study were to compare the clinical features of...

Prostatic disease causes enormous morbidity worldwide. Currently adenocarcinoma of the prostate (ACP) is the most common form of cancer in men in the USA, with a predicted cost of US $8.8 billion for continuing care of these patients by 2020.1 Moreover, benign prostatic hyperplasia (BPH) affects an estimated 70% of men aged 61 -70 years and 90% of those aged 81 -90. By 2025, BPH is likely to affect 20% of the total male population.2 Improved understanding of these diseases could have a significant impact on male health. ACP and BPH are chronic diseases with a long period of development and progression. Interestingly, a self-reported history of prostatitis is associated with ACP and BPH. 3 The role of inflammation in prostatic disease is currently yet to be fully elucidated, although there is emerging evidence that prostatic inflammation may contribute to prostate growth in terms of hyperplastic or neoplastic changes. 4 Histological evidence of inflammation has been reported in approximately 40% of cases of BPH and is associated with a significantly increased risk of acute urinary retention.5 About 20% of all human cancers are caused by chronic inflammation, perhaps including ACP. 6 A better understanding of the relationship between prostatic inflammation and BPH or ACP may provide an opportunity to influence the diagnosis or treatment of prostatic disease.In a previous study, we analysed 405 men presenting with urinary retention and found histological evidence of prostatitis in 98/204 men (48.0%) with BPH and in 51/201 (25.4%) with Objective. To determine the prevalence of prostatitis on histopathological evaluation of prostatic tissue in men without urinary retention. Design, setting and subjects. The clinical data and histopathology reports of men seen from January 1999 through March 2009 at our institution were analysed using Student's t-test, the Mann-Whitney test and Fisher's exact test where appropriate. Values were expressed as means, medians and ranges (p<0.05 accepted as statistically significant). Outcome measures. Data collected included patient age, duration of lower urinary tract symptoms and hospitalisation, findings on digital rectal examination, prostate volume, haemoglobin concentration, serum creatinine and prostate-specific antigen (PSA) levels, and histological findings. Results. Prostatic tissue of 385 men without urinary retention at presentation was obtained via biopsy (48.3% of cases), transurethral prostatectomy (62.9%), retropubic prostatectomy (6.8%) or radical prostatectomy (28.3%). On histological examination, benign prostatic hyperplasia (BPH) was found to be present in 213 patients (55.3%) and adenocarcinoma of the prostate (ACP) in 172 (44.7%). Histological prostatitis was present in 130 patients (61.0%) with BPH and 51 (29.7%) with ACP (p<0.001). A previous study of 405 men presenting with urinary retention at our institution showed histological prostatitis in 98/204 (48.0%) with BPH and in 51/201 (25.4%) with ACP. The group of men with BPH alone had a significantly lower mean se...