Histological prostatitis and its influence on benign prostatic hyperplasia: a systematic review and meta-analysis

Area of Science:

• Urology
• Pathology
• Medical Research

Background:

• Inflammation is a suspected factor in benign prostatic hyperplasia (BPH) development and progression.
• The precise role of inflammation in BPH onset and advancement remains debated.
• This study systematically reviews the impact of histological prostatitis on BPH.

Purpose of the Study:

• To evaluate the influence of histological prostatitis on benign prostatic hyperplasia (BPH).
• To synthesize evidence from existing studies on the association between histological prostatitis and BPH parameters.

Main Methods:

• Systematic search of PubMed, Cochrane Library, Embase, and Web of Science up to April 2025.
• Inclusion of 6 cohort and 5 cross-sectional studies with 3,135 patients.
• Quality assessment using NOS for cohort and JBI for cross-sectional studies; data extraction on PSA, IPSS, PV, Qmax, RUV; meta-analysis using WMD and 95% CIs.

Main Results:

• In cross-sectional studies, histological prostatitis correlated with higher PSA, IPSS, and PV in BPH patients.
• Cohort studies indicated that histological prostatitis was associated with higher PSA and PV, and lower Qmax in BPH patients.
• No statistically significant differences were observed for Qmax in cross-sectional studies, and IPSS and RUV in cohort studies.

Conclusions:

• Histological prostatitis may promote the progression of benign prostatic hyperplasia (BPH).
• Coexisting histological prostatitis is linked to elevated PSA, IPSS, larger PV, and reduced Qmax in BPH patients.
• Clinical consideration of histological prostatitis is recommended for urological patient management.