Does intraprostatic inflammation have a role in the pathogenesis and progression of benign prostatic hyperplasia?

Mishra, Vinod; Allen, Darrell; Nicolaou, Christophoros; Sharif, Haytham; Hudd, Charles; Karim, O.; Motiwala, Hanif; Laniado, Marc

doi:10.1111/j.1464-410x.2007.06910.x

Cited by 121 publications

(94 citation statements)

References 25 publications

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“…Therefore, patients with high-grade prostatic inflammation and IPSS had a significantly greater prostate volume (Mishra et al, 2007). As the prostate volume or PSA levels increase, so do the likelihood of symptom deterioration, the risk of acute urinary retention (AUR), and the possible need for BPHrelated surgery (Roehrborn et al, 1999;Madersbacher et al, 2007;Emberton et al, 2011).Compatible with these findings , according to our results, NLR was associated with IPSS, Qmax and clinical status of patients.…”

Section: Discussionsupporting

confidence: 73%

Is the Neutrophil-Lymphocyte Ratio an Indicator of Progression in Patients with Benign Prostatic Hyperplasia?

Tanık

Albayrak²,

Zengın³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Purpose: The aim of this study was to evaluate inflammation parameters and assess the utility of the neutrophillymphocyte ratio (NLR) as a simple and readily available predictor for clinical disease activity in patients with nenign prostate hyperplasia BPH. We also aimed to investigate the relationship between inflammatory parameters with α-blocker therapy response, and evaluate the potential association between NLR and the progression of benign prostatic hyperplasia (BPH). Materials and Methods: We examined 320 consecutive patients ( .001); however, there were no significant differences between the groups in terms of age (p>0.05), and prostate volume (p>0.05). Conclusions: NLR can predict BPH progression. We propose that increased inflammation is negatively associated with clinical status in BPH patients and suggest that NLR can give information along with LUTS severity which may be used as a readikly accessible marker for patient follow-up.

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Section: Discussionsupporting

confidence: 73%

Is the Neutrophil-Lymphocyte Ratio an Indicator of Progression in Patients with Benign Prostatic Hyperplasia?

Tanık

Albayrak²,

Zengın³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Recent studies have evaluated the relationship between chronic prostatic inflammation with urinary retention and BPH progression with the finding that patients with chronic prostate inflammation have significantly higher risk of retention 25 . Recurrent UTI and chronic urinary catheterization can all hypothetically increase prostate inflammation, although studies examining this relationship have failed to demonstrate consistent findings 25,26 . Prostate inflammation impacts the histologic architecture, increasing gland volume and obliterates the natural plane between adenoma and prostate capsule which may result in a more complicated dissection during enucleation.…”

Section: Discussionmentioning

confidence: 99%

“…Inflamed prostate tissue may also trigger increased bleeding or oozing while operating which may result in poorer visualization requiring increased time to achieve appropriate hemostasis during surgery. Furthermore, changes in gland volume and tissue quality may hinder morcellation as well, increasing surgical times in this select group of patients 25,26 . In our study, requiring a Foley at the time of HoLEP was not associated with increases in either enucleation or morcellation time.…”

Section: Discussionmentioning

confidence: 99%

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Predictors of Enucleation and Morcellation Time During Holmium Laser Enucleation of the Prostate

Monn

Tayeb

Bhojani

et al. 2015

Urology

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Objectives: To examine predictors of enucleation and morcellation time within a large cohort of men undergoing HoLEP for benign prostatic hypertrophy.Methods: Pre-operative, peri-operative, and post-operative clinical characteristics were available from men treated with HoLEP between 1998 and 2013 at Indiana University Health Methodist Hospital. Stepwise linear regression was performed to determine clinical variables which are associated with enucleation and morcellation times. Results:We identified 960 patients who underwent HoLEP. Average (range) enucleation time was 65.7 (11-245) minutes and morcellation time was 19.7 (3-260) minutes. History of anticoagulation was associated with a small decrease in enucleation time (p=0.013) while increasing HoLEP specimen weight was associated with increasing enucleation time (p<0.001).History of intermittent catheterization, urinary tract infections, presence of dense prostatic tissue (colloquially referred to as "beach balls"), and increasing specimen weight were associated with increasing morcellation time (p<0.05 each). Having HoLEP performed by a less experienced urologist was associated with longer enucleation and morcellation times. Conclusions:Prostate volume is significantly associated with increased enucleation and morcellation times during HoLEP. Additionally, history of UTI and CIC are associated with modest increases in enucleation and morcellation times. Dense enucleated prostate tissue significantly impacts the ability to morcellate effectively. Increasing surgeon experience can significantly improve both enucleation and morcellation efficiency.3

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“…The presence of chronic histologic inflammation is a common finding in prostatic tissue on biopsies of surgical specimens from patients with and without lower urinary tract symptoms (LUTS) or prostatitis (1)(2)(3). Although it is not yet defined when and why chronic inflammation occurs, it has been hypothesized that BPH is an immune-mediated inflammatory disease (2,4,5).…”

Section: Introductionmentioning

confidence: 99%

Effects of prostatic inflammation on LUTS and alpha blocker treatment outcomes

et al. 2014

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ARTICLE INFO ______________________________________________________________ ______________________Purpose: 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. Materials and 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 (3-20ng/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.

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Does intraprostatic inflammation have a role in the pathogenesis and progression of benign prostatic hyperplasia?

Cited by 121 publications

References 25 publications

Is the Neutrophil-Lymphocyte Ratio an Indicator of Progression in Patients with Benign Prostatic Hyperplasia?

Is the Neutrophil-Lymphocyte Ratio an Indicator of Progression in Patients with Benign Prostatic Hyperplasia?

Predictors of Enucleation and Morcellation Time During Holmium Laser Enucleation of the Prostate

Effects of prostatic inflammation on LUTS and alpha blocker treatment outcomes

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