Chronic Prostate Inflammation is Associated with Severity and Progression of Benign Prostatic Hyperplasia, Lower Urinary Tract Symptoms and Risk of Acute Urinary Retention

and Objectives: We evaluated associations between histological prostate inflammation and development and progression of BPH/LUTS in men randomized to placebo in the REDUCE study over a 4-year period.

The association of acute and chronic inflammation detected on baseline biopsies and BPH related parameters (IPSS, prostate volume) at multiple time points over 4 years in men randomized to placebo enrolled in the REDUCE prostate cancer prevention study was analyzed with Students t test. The association of inflammation with newly developed BPH/LUTS and BPH progression in patients with existing BPH/LUTS was analyzed with uni- and multivariable Cox model.

Acute and chronic inflammation was seen in baseline negative biopsies of 641 (15.6%) and 3216 (78.3%) of 4109 men in study. Chronic but not acute inflammation was associated with slightly higher baseline IPSS (difference=0.6, p=0.001) and larger prostate volume (difference=3.2cc, p<0.001), a difference noted throughout the study interval. The presence of acute and chronic inflammation was not associated with the incidence of BPH/LUTS in men without BPH/LUTS at baseline or the progression of symptomatic BPH in men who had BPH/LUTS at baseline but an association was observed with more severe inflammation. Chronic inflammation at baseline was associated with increase risk of AUR (HR=1.6-1.8, p=0.001).

Our longitudinal evaluation of REDUCE patients randomized to placebo for 4 years confirmed that chronic inflammation is associated with severity and progression of BPH and BPH/LUTS outcomes.

The Journal of urology. 2016 Jul 01 [Epub ahead of print]

J Curtis Nickel, Claus G Roehrborn, Ramiro Castro-Santamaria, Stephen J Freedland, Daniel M Moreira

Department of Urology, Queen's University, Kingston, ON, Canada., Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA., GlaxoSmithKline Inc., Global R&D Unit, King of Prussia, PA, USA., Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Department of Urology, Mayo Clinic, Rochester, MN, USA.

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