Prostatic stromal inflammation is associated with bladder outlet obstruction in patients with benign prostatic hyperplasia

Inamura, So; Ito, Hiroki; Shinagawa, Tomochika; Tsutsumiuchi, Manami; Taga, Minekatsu; Kobayashi, Motohiro; Yokoyama, Osamu

doi:10.1002/pros.23518

Cited by 18 publications

(11 citation statements)

References 15 publications

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“…The sections were counterstained with haematoxylin‐eosin and inflammatory changes in the prostate and urinary bladder were assessed blindly by a pathologist (PUG). Histopathological analysis followed the same procedure as a previous study 18 that used a grading scale (Table 1) to categorize prostatic inflammation based on the magnitude or density of lymphocytes (grade) and the extent or distribution of lymphocyte infiltration (extent). The grade of prostatic and bladder inflammation was scored from 0 to 3 where 0 represented no inflammation and 3 represented severe inflammation (Figure 2).…”

Section: Methodsmentioning

confidence: 99%

“…T A B L E 1 Grading scales of inflammatory changes in the prostate and bladder. The procedure for determination of grade and extent of inflammation were adapted from Inamura et al 18 Grade (inflammatory cell density, cells/mm 2 ) 30.17 ± 9.72, p = .046; control vs. Z14: 1.00 ± 0.31 vs. 33.40 ± 8.13, p = .033; control vs. Z21: 1.00 ± 0.31 vs. 35.83 ± 9.44, p = .014). No significant differences could be seen in regard to NVCs between the CPPS groups.…”

Section: Cystometrymentioning

confidence: 99%

“…Histopathological analysis followed the same procedure as a previous study 18 that used a grading scale (Table 1) 3 | RESULTS…”

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confidence: 99%

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Prostate‐to‐bladder cross‐sensitization in a model of zymosan‐induced chronic pelvic pain syndrome in rats

et al. 2021

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Background: The aim of the present study was to investigate the effects of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) on bladder function and pathophysiology. Methods: To create a model for CPPS, rats were intraprostatically injected with zymosan or saline, serving as control. Metabolic cage experiments were performed 7, 14, or 21 days after zymosan injection and after 14 days in the control group. Thereafter, cystometry was performed in which simulated micturition cycles were induced by saline infusion and contractile responses to the cholinergic agonist methacholine and the purinergic agonist ATP were measured. Following cystometry, the prostate and urinary bladder were excised and assessed histopathologically for possible inflammatory changes. Results: Metabolic cage data revealed a significantly increased urinary frequency in zymosan treated rats. Likewise, the volume per micturition was significantly lower in all CPPS groups compared to controls. Cystometry showed a significant increase in the number of nonvoiding contractions, longer voiding time, and a trend towards lower compliance in CPPS rats compared to controls. Induction of CPPS led to significantly reduced cholinergic and purinergic contractile responses. Histopathological analysis demonstrated prostatic inflammation in all CPPS groups, in particular in later stage groups. Both the extent and grade of bladder inflammation were significantly higher in CPPS groups compared to controls. Conclusions: The current findings demonstrate a potential prostate-to-bladder cross-sensitization leading to symptoms of bladder overactivity and signs of bladder inflammation. Future clinical studies are required to verify the outcomes of the current study and enable advancement of patient care.

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Section: Methodsmentioning

confidence: 99%

Section: Cystometrymentioning

confidence: 99%

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Prostate‐to‐bladder cross‐sensitization in a model of zymosan‐induced chronic pelvic pain syndrome in rats

et al. 2021

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“…By observing the TURP and HoLEP samples of 179 BPH patients, the patients were divided into stromal group and nonstromal groups according to whether or not the main site of chronic inflammation occurred in the stromal tissue. The stromal group was found to have a significantly larger total prostate volume (TPV) than the nonstromal group (63.8 vs. 53.8mL; P = 0:032), and the incidence of AUR was significantly increased (36.1% vs. 11.4%; P = 0:006) [31]. There were also significant differences in urinary indicators.…”

Section: The Role Of Inflammation In Bphmentioning

confidence: 96%

Review of the Roles and Interaction of Androgen and Inflammation in Benign Prostatic Hyperplasia

Tong

Zhou

2020

Mediators of Inflammation

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The lower urinary tract symptoms (LUTSs) and acute urinary retention (AUR) caused by benign prostatic hyperplasia (BPH) can seriously affect the quality of life of elderly men. Studies suggest that both androgens and inflammation greatly influence the occurrence and development of BPH in most patients. These two factors combined can also affect each other, leading to pathological changes in the stromal and epithelial tissue of the prostate transition zone in BPH patients. DHT in the prostate tissue of BPH patients may activate a chronic inflammatory response in the prostate, amplifying the expression of inflammatory factors and upregulating the proliferation ability of prostate tissue.

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“…Chronic inflammation can be found in most BPH pathological specimens (11)(12)(13); thus, BPH has been regarded as an immune inflammatory disease (14)(15)(16). Relevant studies have confirmed that prostatic inflammation is strongly correlated with AUR in BPH patients (17)(18)(19)(20)(21)(22). Moreover, the severity of the inflammatory response is positively associated with both the occurrence of AUR and the requirement for surgical operations (23).…”

Section: Introductionmentioning

confidence: 99%

Serum interleukin 6 and acute urinary retention in elderly men with benign prostatic hyperplasia in China: a cross-sectional study

Wu¹,

Shi²,

Ding³

et al. 2021

Transl Androl Urol

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Background: While acute urinary retention (AUR) is a severe complication of benign prostatic hyperplasia (BPH), it can also indicate the progression of this common disease in aging men. This study aimed at exploring the possible relationship between serum interleukin 6 (sIL-6) and AUR in BPH patients. Methods: A cross-sectional study was conducted based on 256 elderly men with BPH in China. The association between the sIL-6 level and the occurrence of AUR was evaluated by univariate and multivariable logistic regressions. The receiver operating characteristic (ROC) curve was utilized to determine the discriminant validity of the sIL-6 level and the optimal cutoff value. Results: The concentration of sIL-6 was significantly elevated in the AUR group (P<0.001). A positive correlation was observed between the sIL-6 level and AUR in BPH patients [odds ratio (OR) =1.365, 95% confidence interval (CI): 1.174-1.586, P<0.001]. Based on the ROC curve analysis for sIL-6, the optimal cutoff point of 4.475 pg/mL was set to identify the occurrence of AUR in these patients [area under the curve (AUC) =0.7596, 95% CI: 0.6976-0.8216, P<0.001]. A high sIL-6 level (≥4.475 pg/mL) had a significantly stronger correlation with AUR (OR =9.666, 95% CI: 4.347-21.491, P<0.001). Conclusions: There was a positive correlation between the sIL-6 level and the occurrence of AUR in elderly Chinese patients with BPH. This study provides potential strategies for the screening of BPH individuals with a possible risk of AUR, which may contribute to the early implementation of effective interventions to improve the quality of life and prognosis. Long-term prospective studies are still required to further illustrate the causal relationship.

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Prostatic stromal inflammation is associated with bladder outlet obstruction in patients with benign prostatic hyperplasia

Abstract: The location of inflammation in the prostate might be an important factor affecting the severity of LUTS, especially voiding dysfunction.

Cited by 18 publications

References 15 publications

Prostate‐to‐bladder cross‐sensitization in a model of zymosan‐induced chronic pelvic pain syndrome in rats

Prostate‐to‐bladder cross‐sensitization in a model of zymosan‐induced chronic pelvic pain syndrome in rats

Review of the Roles and Interaction of Androgen and Inflammation in Benign Prostatic Hyperplasia

Serum interleukin 6 and acute urinary retention in elderly men with benign prostatic hyperplasia in China: a cross-sectional study

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