Is there a link between prostate inflammation and BPH?

This study examined the effect of prostate inflammation on the later development or progression of benign prostatic hyperplasia (BPH). Researchers reported that the development or progression of BPH was overall not significantly increased by previous prostate inflammation.

Inflammation is the body’s response to injury and infection. Like any tissue in the body, the prostate can become inflamed, often caused by a bacterial infection. Prostate inflammation can be acute (rapid onset and short course) or chronic (longer, undefined course). Some studies have suggested that prostate inflammation is linked to the development and progression of BPH and related urinary symptoms. However, this association is still being investigated.

The aim of this study was to examine the link between prostate inflammation and BPH.

4,109 men were included in this study. The men had participated in an earlier, separate trial on BPH medication and had been randomly assigned to receive a placebo (a control drug with no active effect). Prostate tissue samples measured the presence of prostate inflammation at the beginning of the study. Development or progression of BPH was followed for 4 years.

78.3% of men had chronic prostate inflammation at the beginning of the study. 15.6% of men had acute inflammation. Men with chronic inflammation reported more severe urinary symptoms and had significantly larger prostates.

797 of the men included did not have BPH at the beginning of the study. 11.7% of these men developed BPH during the study period. Acute or chronic inflammation was not associated with the onset of BPH.

Of the men with a diagnosis of BPH at the beginning of the study, 47.5% experienced a progression of BPH. The presence of acute inflammation at the beginning of the study was not associated with BPH progression. However, men with moderate-to-severe chronic inflammation were slightly more likely to experience BPH progression over 4 years.

Urinary retention (a temporary inability to pass urine that requires treatment) occurred in 262 men. 221 of these men had a previous diagnosis of BPH. Chronic inflammation significantly increased the risk of later developing urinary retention.

Researchers concluded that chronic prostate inflammation is associated with more severe urinary symptoms, larger prostates, and an increased risk of urinary retention. However, prostate inflammation generally did not predict the development or progression of BPH over 4 years.

Only 93 men developed BPH during the study period. Larger studies are therefore needed to confirm these findings.