Purpose: To evaluate the association between inflammation in prostatic tissue/serum sample and BPH-LUTS
Patients and methods: The prostatic tissue and serum sample were collected from 183 patients who underwent transurethral plasmakinetic resection of the prostate (TUPKRP). The association between inflammation detected on prostatic tissues/ serum sample and LUTS related parameters, including International Prostate Symptom Score (IPSS) and peak flow rate (Qmax) were analyzed with SPSS version 13.0, and P-value <0.05 was chosen as the criterion for statistical significance.
Results: There was a positive association between prostate tissue inflammation and LUTS. The differences of IPSS, VSS and SSS were seen with the increasing in grade of prostate tissue inflammation (P<.001; .001; =.014, respectively). Qmax and IPSS 12months after surgery were better in no inflammation group (P=.016; .031).Logistic regression analysis revealed a statistically association between the NEUT%?NLR and prostate tissue inflammation (P=.010; .004), but ROC curve showed the NEUT%, NEUT and NLR area under curve (.526; .452; .513, respectively) were calculated as <0.600. Patients with Qmax over 7.12 had more WBC count in peripheral blood (7.56±1.77 VS 6.37±1.86, P=.026). The NLR was significantly higher in the group of IPSS over 20 and AUR presence (P=.018; .017).The NEUT%, LYMPH%, LYMPH and NLR showed a statistically significance in different obstruction classification (P=.047; .046; .028; .014, respectively).
Conclusion: There was correlation between chronic Inflammation and LUTS related to BPH. The patient without inflammation could acquire more sustained and steady relief than those with inflammation in LUTS related to BPH after TUPKRP.
Torkko KC, Wilson RS, Smith EE, et al. Prostate Biopsy Markers of Inflammation are Associated with Risk of Clinical Progression of Benign Prostatic Hyperplasia: Findings from the MTOPS Study. The Journal of urology. 2015; 194:454-461.
Nickel JC, Roehrborn CG, O'Leary MP, et al. The relationship between prostate inflammation and lower urinary tract symptoms: examination of baseline data from the REDUCE trial. Eur Urol. 2008; 54:1379-1384.
Kim SH, Jung KI, Koh JS, et al. Lower urinary tract symptoms in benign prostatic hyperplasia patients: orchestrated by chronic prostatic inflammation and prostatic calculi? Urol Int. 2013; 90:144-149.
Nickel JC, Roehrborn CG, Castro-Santamaria R, et al. Chronic Prostate Inflammation is Associated with Severity and Progression of Benign Prostatic Hyperplasia, Lower Urinary Tract Symptoms and Risk of Acute Urinary Retention. The Journal of urology. 2016; 196:1493-1498.
Taoka R, Kakehi Y. The influence of asymptomatic inflammatory prostatitis on the onset and progression of lower urinary tract symptoms in men with histologic benign prostatic hyperplasia. Asian J Urol. 2017; 4:158-163.
Fujita K, Hosomi M, Nakagawa M, et al. White blood cell count is positively associated with benign prostatic hyperplasia. Int J Urol. 2014; 21:308-312.
Ozer K, Horsanali MO, Gorgel SN, et al. Association between Benign Prostatic Hyperplasia and Neutrophil-Lymphocyte Ratio, an Indicator of Inflammation and Metabolic Syndrome. Urol Int. 2017; 98:466-471.
Bostanci Y, Kazzazi A, Momtahen S, et al. Correlation between benign prostatic hyperplasia and inflammation. Curr Opin Urol. 2013; 23:5-10.
Gandaglia G, Briganti A, Gontero P, et al. The role of chronic prostatic inflammation in the pathogenesis and progression of benign prostatic hyperplasia (BPH). BJU Int. 2013; 112:432-441.
Ribal MJ. The Link Between Benign Prostatic Hyperplasia and Inflammation. European Urology Supplements. 2013; 12:103-109.
Robert G, Descazeaud A, Nicolaiew N, et al. Inflammation in benign prostatic hyperplasia: a 282 patients' immunohistochemical analysis. Prostate. 2009; 69:1774-1780.
Inamura S, Ito H, Shinagawa T, et al. Prostatic stromal inflammation is associated with bladder outlet obstruction in patients with benign prostatic hyperplasia. Prostate. 2018; 78:743-752.
St Sauver JL, Jacobson DJ, McGree ME, et al. Protective association between nonsteroidal antiinflammatory drug use and measures of benign prostatic hyperplasia. Am J Epidemiol. 2006; 164:760-768.
Lee HN, Kim TH, Lee SJ, et al. Effects of prostatic inflammation on LUTS and alpha blocker treatment outcomes. Int Braz J Urol. 2014; 40:356-366.
Gacci M, Andersson KE, Chapple C, et al. Latest Evidence on the Use of Phosphodiesterase Type 5 Inhibitors for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia. Eur Urol. 2016; 70:124-133.
Ficarra V, Rossanese M, Zazzara M, et al. The role of inflammation in lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) and its potential impact on medical therapy. Curr Urol Rep. 2014; 15:463.
Hu J, Zhang L, Zou L, et al. Role of inflammation in benign prostatic hyperplasia development among Han Chinese: A population-based and single-institutional analysis. Int J Urol. 2015; 22:1138-1142.
De Nunzio C, Brassetti A, Gacci M, et al. Patients With Prostatic Inflammation Undergoing Transurethral Prostatic Resection Have a Larger Early Improvement of Storage Symptoms. Urology. 2015; 86:359-365.
S A, K Z, H B, et al. Is the neutrophil-lymphocyte ratio an indicator of progression in patients with benign prostatic hyperplasia?%A Tanik S. 2014; 15:6375-6379.
Buyukkaya E, Karakas MF, Karakas E, et al. Correlation of neutrophil to lymphocyte ratio with the presence and severity of metabolic syndrome. Clin Appl Thromb Hemost. 2014; 20:159-163.
Stotz M, Gerger A, Eisner F, et al. Increased neutrophil-lymphocyte ratio is a poor prognostic factor in patients with primary operable and inoperable pancreatic cancer. Br J Cancer. 2013; 109:416-421.