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Asymptomatic inflammation and/or infection in benign prostatic hyperplasia
J C Nickel1, J Downey, I Young
1Department of Urology, Queen's University, Kingston, Ontario, Canada. jcn@post.queensu.ca
BJU International
|November 26, 1999
Summary
Histological inflammation is common in benign prostatic hyperplasia (BPH) patients without prostatitis symptoms. However, this inflammation and latent infection (National Institute of Health Category IV prostatitis) showed no correlation with PSA levels or catheterization.
Area of Science:
- Urology
- Pathology
- Medical Research
Background:
- Benign prostatic hyperplasia (BPH) is a common condition in aging men.
- Asymptomatic histological inflammation, termed National Institute of Health Category IV prostatitis, may coexist with BPH.
- The clinical significance of this asymptomatic inflammation in BPH is not well understood.
Purpose of the Study:
- To investigate the prevalence, patterns, and clinical significance of asymptomatic histological inflammation and latent infection in patients with BPH.
- To correlate inflammation characteristics with bacterial presence, catheterization, and prostate-specific antigen (PSA) levels.
Main Methods:
- Analysis of 80 BPH patients undergoing transurethral resection of the prostate (TURP).
- Histological examination of prostate tissue for inflammation (leukocyte common antigen staining, computerized image analysis).
- Categorization of inflammation patterns and grading of cell density; correlation with deep prostatic biopsy cultures, catheterization history, and PSA levels.
Main Results:
- All patients exhibited histological inflammation, with a mean involvement of 1.1% of tissue surface area; periglandular inflammation was most common.
- Bacterial growth was found in 44% of specimens, higher in catheterized patients.
- No significant correlations were found between inflammation patterns/grades and catheterization status or bacterial presence.
- Neither total PSA nor PSA density correlated significantly with the amount, degree, or distribution of inflammation.
Conclusions:
- Asymptomatic histological inflammation (National Institute of Health Category IV prostatitis) is highly prevalent in BPH patients without prostatitis symptoms.
- The degree and pattern of inflammation, catheterization, bacterial presence, and PSA levels are not significantly correlated in this cohort.
- The clinical relevance of asymptomatic chronic prostatitis associated with BPH requires further investigation.