The effect of prostatic inflammation on clinical outcomes in patients with benign prostate hyperplasia

Cakir, Suleyman Sami; Polat, Emre Can; Özcan, Levent; Beşiroğlu, Hüseyin; Ötünçtemur, Alper; Ozbek, Emin

doi:10.1016/j.prnil.2017.12.003

Cited by 16 publications

(21 citation statements)

References 19 publications

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“…Despite the variation in prostate size reduction after intervention between the 3 groups, IPSS score improvement was nearly similar in all groups; this may be due to asymptomatic prostatic inflammation that affects the LUTSs as mentioned by Cakir et al. 12 In addition, the subjectivity of IPSS score and patient to patient variability and the different education level as mentioned by Taneja et al 13 2017, that education level may be affected and the visual prostate symptom score would be more appropriate in comparison to IPSS.…”

Section: Discussionmentioning

confidence: 68%

Prostatic artery embolization versus transurethral resection of the prostate in management of benign prostatic hyperplasia

Radwan

Farouk

Higazy

et al. 2020

Prostate International

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Background Transurethral resection of the prostate (TURP) is considered the gold standard surgical intervention for prostate size less than 80 g. Prostatic artery embolization (PAE) has been suggested as a minimally invasive interventional radiological procedure in the management of benign prostatic hyperplasia (BPH), especially by using the PErFecTED technique. We aim through our study to evaluate the efficacy and safety of PAE compared with those of monopolar transurethral resection of prostate (M-TURP) and bipolar transurethral resection of prostate (B-TURP) in treating lower urinary tract symptoms (LUTSs) secondary to BPH. Methods We randomized 60 patients into 3 equal groups representing M-TURP, B-TURP, and PAE. Patients were followed up at 1 and 6 months postoperatively with regard to the International prostate symptom score (IPSS) score; uroflowmetry; prostate volume by transrectal ultrasound; and postvoid residual urine. Results The mean operative time was 59, 68, and 89 minutes for the M-TURP group, the B-TURP group, and the PAE group, respectively; only one patient, who represented 5% of the M-TURP group and 1.7% of the whole study population, developed transurethral resection syndrome. Four patients of the PAE group complained of postembolization syndrome, which represented 20% of the cases. Only two patients in our study, both belonging to the PAE group, developed acute urinary retention after catheter removal, representing 10% of the PAE group and 3.33% of the whole study population. The improvement in the IPSS score, the average uroflowmetry (Q-average) score, postvoid residual urine, and prostate volume reduction was noted in all groups, with more statistically significant improvement in each of the M-TURP and the B-TURP groups than in the PAE group. Conclusion PErFecTED technique is a novel way of embolization, with statistically significant improvement for patients complaining of LUTSs due to BPH in terms of improvement of IPSS, uroflowmetry, prostate size, and amount of postvoid residual urine, yet these results are still not comparable with either the results of M-TURP or B-TURP that still show more effective improvement.

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Section: Discussionmentioning

confidence: 68%

Prostatic artery embolization versus transurethral resection of the prostate in management of benign prostatic hyperplasia

Radwan

Farouk

Higazy

et al. 2020

Prostate International

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“…This finding suggested that periodontal scaling should be covered in routine healthcare for old males and that BPH therapy should be accompanied by periodontal treatment. In addition, asymptomatic prostate inflammation can worsen lower urinary tract symptoms and urinary flow rate in patients with BPH [41], while periodontal treatment can effectively reduce such risks. Additionally, basic laboratory studies have demonstrated that infections by periodontal pathogens can accelerate some systemic conditions by inciting inflammatory responses and further affecting apoptosis, and the mechanisms have been corroborated in atheroma deposition [42], preterm low birth weight among infants [43], cognitive decline [44] and respiratory infection [45] but not in BPH until now.…”

Section: Discussionmentioning

confidence: 99%

Periodontal disease and risk of benign prostate hyperplasia: a cross-sectional study

Wang

et al. 2019

Military Med Res

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BackgroundBoth periodontal disease and benign prostatic hyperplasia are age-related diseases that affect millions of people worldwide. Hence, this study aimed to investigate the association between periodontal disease and the risk of benign prostatic hyperplasia.MethodsA total of 4930 participants were selected from an available health examination that was carried out in 2017, only males were considered for further analysis. All eligible males were divided into benign prostatic hyperplasia and normal groups, the benign prostatic hyperplasia group was then divided into prostate volume ≤ 60 g and > 60 g subgroups; all their periodontal status was extracted and then into normal (CPI score of 0), periodontal disease (CPI score between 1 and 4), and periodontitis (CPI score between 3 and 4) groups. The correlation between periodontal disease and benign prostatic hyperplasia was investigated using logistic regression analyses and greedy matching case-control analysis. Subgroup analysis based on prostate volume was also performed. All analyses were conducted with SAS 9.4 software.ResultsA total of 2171 males were selected for this analysis. The presence of periodontal disease significantly increased the risk of benign prostatic hyperplasia by 1.68 times (OR = 1.68, 95% CI: 1.26–2.24), and individuals with periodontitis showed a higher risk (OR = 4.18, 95% CI: 2.75–6.35). In addition, among matched cases and controls, this association remained robust (periodontal disease: OR = 1.85, 95% CI: 1.30–2.64; periodontitis: OR = 4.83, 95% CI: 2.57–9.07). Subgroup analysis revealed that periodontal disease significantly increased benign prostate hyperplasia risk as well (for prostate volume ≤ 60 g: OR = 1.64, 95% CI: 1.22–2.20; for volume > 60 g: OR = 2.17, 95% CI: 1.04–4.53), and there was a higher risk in the group with a prostate volume greater than 60 g.ConclusionPeriodontal disease is significantly and positively associated with an increased risk of benign prostatic hyperplasia. Further validation studies should be performed to explore the relationship between periodontal treatment and benign prostate hyperplasia.

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“…A retrospective study of 428 TURP specimens showed that those with evidence of chronic prostatitis had a significantly higher preoperative IPSS (29.9 vs 23). Despite addressing their outlet obstruction, they had worse outcomes at 1 year than the group without prostatitis [28]. However, these results were again confounded by a higher rate of preoperative urethral catheterization in the group with prostatitis (24% vs 11%).…”

Section: Aurmentioning

confidence: 97%

Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms: What Is the Role and Significance of Inflammation?

2019

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Purpose of Review:The purpose of this review is to summarize the role and significance of inflammation as a putative third factor contributing to lower urinary tract symptoms and the progression of benign prostatic hyperplasia. We review (1) the histologic definition of prostatic inflammation and its prevalence, (2) the effects inflammation in the prostate including on risk of acute urinary retention, (3) the effects of systemic inflammation on the prostate and on voiding.Recent Findings: Inflammation is a highly prevalent finding in the prostate, both on a histological and biochemical level. Men with inflammation have higher IPSS scores and increased prostate size; however, these differences appear to be imperceptibly small. Men with inflammation do experience a significantly increased risk of developing acute urinary retention, an event that is associated with significant morbidity. Recently, attempts have been made to identify more specific biochemical markers of local inflammation, and to identify regional patterns of inflamed tissue within the prostate which may be associated with higher IPSS scores, accelerated progression, and AUR. The effects of systemic inflammatory states, most notably MetS, and their role in LUTS has also been examined. Summary:Inflammation is a common finding in prostates of ageing men, but its contribution to lower urinary tract symptoms and benign prostatic hyperplasia progression appears to be small when considered as a clinically relevant entity. Advances in the understanding of different forms of inflammation, and their impact when experienced in different locations within the prostate, may refine this knowledge. Systemic inflammation affects voiding, including in the absence of a prostate, but again significant effects of systemic inflammation on the prostate itself are also difficult to demonstrate. Prostatic inflammation is associated with a significantly increased risk of acute urinary retention.

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The effect of prostatic inflammation on clinical outcomes in patients with benign prostate hyperplasia

Cited by 16 publications

References 19 publications

Prostatic artery embolization versus transurethral resection of the prostate in management of benign prostatic hyperplasia

Prostatic artery embolization versus transurethral resection of the prostate in management of benign prostatic hyperplasia

Periodontal disease and risk of benign prostate hyperplasia: a cross-sectional study

Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms: What Is the Role and Significance of Inflammation?

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