Metabolic Syndrome and Lower Urinary Tract Symptoms in Patients With Benign Prostatic Enlargement: A Possible Link to Storage Symptoms

Patients With Prostatic Inflammation Undergoing Transurethral Prostatic Resection Have a Larger Early Improvement of Storage Symptoms

“…2,6,7 Although the pathophysiological link beyond this association is still to be determined, prostatic inflammation, which is highly prevalent in patients with MetS, has been considered one of the most important factors involved in this association. 8 Gacci et al 2 recently retrospectively evaluated the association between MetS, defined according to the ATP-III criteria, and LUTS in a group of Italian patients with LUTS and/or BPE treated with open or endoscopic prostatectomy, and they demonstrated an association among MetS features, the presence and grade of prostatic inflammation, and prostate enlargement.…”

Re: Association Between Metabolic Syndrome and Severity of Lower Urinary Tract Symptoms: An Observational Study in a 4666 European Men Cohort

“…Recently, epidemiologic and clinical studies in American and Asian populations have provided emerging evidence of a possible role for MS and its components in the occurrence and progression of LUTS [1,2]. In Europe, we recently observed that MS is a frequently occurring (24%) condition in patients with LUTS, and its presence increased the risk of having an IPSS storage subscore 4 in patients with LUTS by about 80% (OR: 1.78; 95% CI, 1.045-3.042; p = 0.03) [3]. Although the study presented by Pashootan et al confirmed these observations in Western Europe and further increased the evidence of the relationship between MS and LUTS, the study did not investigate the biological mechanism beyond this association.…”

“…Second, among patients who were initially treated with nephrectomy plus LND, the median number of lymph nodes removed was only 4.5 (with a maximum of 7). According to the above-cited clinical characteristics and based on the most accurate predictive tools available in the literature [2][3][4], patients should have been treated with a primary extended LND for high risk of lymph node invasion and/or lymph node progression. Since the primitive tumor was completely removed at initial surgery, it is plausible that observed RCC-NRs were due to lack of adequate LND at the time of surgery [1].…”

“…A recent nested case-control study showed an association between metformin use and a decreased risk of PCa [2], whereas the Metformin Active Surveillance Trial (MAST) is currently exploring whether metformin will delay pathologic progression of PCa [3].…”

Urinary Urgency in the Elderly

“…Although some studies demonstrate an association with benign prostate volume and MetS, the lower urinary tract symptoms best correlated with MetS are those of storage [20]. Most obesity studies have examined morbidly obese patients with an endpoint of overall urinary incontinence; the strongest effect is on stress urinary incontinence (SUI).…”