Clinical Importance of Histopathological Inflammation in Patients with Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Prospective Study of 222 Patients

Abstract

Objective: To investigate the relationship between the severity of histopathological prostatic inflammation with lower urinary tract symptoms and prostate specific antigen (PSA) levels. Methods: We prospectively included 222 consecutive patients eligible for transurethral resection of the prostate in a non-academic referral center by a single surgeon. Patients with proven urinary tract infection or prostate cancer were excluded. Preoperative assessment included PSA levels, International Prostate Symptom Score (IPSS), mean peak flow, mean resected prostate weight and post-residual volume. Finally, the presence and severity of inflammation was determined histopathologically. Results: Mean patient age was 69.1 ± 8.6 years with mean preoperative PSA levels of 4.7 ± 5.4 ng/mL and IPSS of 15.7 ± 6.9. Mean peak flow was 10.7 ± 6.5 ml/s and the mean resected prostate weight 39.4 ± 27.3 g. Positive correlations between PSA (log) and prostate weight (r = 0.54, p < 0.001) and between PSA (log) and active (r = 0.30, p < 0.0001) and chronic inflammation (r = 0.19, p = 0.005) were observed. No correlations were found between IPSS and PSA (log) (r = -0.14, p = 0.040) or between IPSS and active inflammation (p = 0.659) or chronic inflammation (p = 0.125). Conclusion: The study showed a weak correlation between PSA and the active or chronic inflammation. It also showed that there was no correlation between the active or chronic histopathological inflammation and IPSS.

Improvement of urinary tract symptoms and quality of life in benign prostate hyperplasia patients associated with consumption of a newly developed whole tomato-based food supplement: a phase II prospective, randomized double-blinded, placebo-controlled study

“…It is a condition of which subclinical inflammation may be associated with a rise in serum PSA levels [ 37 ]. However weak is the correlation between PSA levels and the active or chronic inflammation and no significant correlation exists between the active or chronic histopathological inflammation and IPSS [ 38 ]. Also, in this regard nutritional interventions with tomato-products reduced PSA levels in subgroups of prostate patients, while lycopene supplements or extracts were found to be less effective [ 39 – 42 ].…”

Improvement of Urinary Tract Symptoms and Quality of Life in Benign Prostate Hyperplasia Patients, Associated with Consumption of a Newly Developed whole Tomato Based Food Supplement. A phase II prospective, Randomized Double-blinded, Placebo-controlled Study.

“…It is a condition of which subclinical in ammation may be associated with a raise of serum PSA levels [36]. However weak is the correlation between PSA levels and the active or chronic in ammation and no signi cant correlation exists between the active or chronic histopathological in ammation and IPSS [37]. Also, in this regard nutritional interventions with tomato-products reduced PSA levels in subgroups of prostate patients, while lycopene supplements or extracts were found to be less effective [38][39][40][41].…”

Improvement of urinary tract symptoms and quality of life in Benign Prostate Hyperplasia patients, associated with consumption of a newly developed whole tomato-based food supplement. A phase II prospective, randomized double-blinded, placebo-controlled study.

“…It is a condition of which subclinical in ammation may be associated with a rise in serum PSA levels [37]. However weak is the correlation between PSA levels and the active or chronic in ammation and no signi cant correlation exists between the active or chronic histopathological in ammation and IPSS [38]. Also, in this regard nutritional interventions with tomato-products reduced PSA levels in subgroups of prostate patients, while lycopene supplements or extracts were found to be less effective [39][40][41][42].…”