Correlation between chronic prostate inflammation and overactive bladder symptoms following transurethral resection of the prostate due to benign prostate hyperplasia.

objectivesTreatment of patients with lower urinary tract symptoms (LUTS) is often challenging. In men, the origin of LUTS, in particular overactive bladder (OAB) symptoms, is often due to prostate enlargement. However, patients with chronic prostate inflammation (CPI) also frequently experience OAB. Thus far, it is not known if the inflammation per se or concomitant prostate enlargement is the underlying cause of LUTS. Currently, we aim to examine if there is any correlation between CPI and the persistence of OAB symptoms in patients with benign prostate hyperplasia (BPH).

methodsFifty-one men underwent transurethral resection of the prostate (TUR-P). Based on pathological examination, the patients were divided into two groups, i.e., those with and without prostate inflammation. All patients were examinedwith the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), international prostate symptom score (IPSS) and overactive bladder questionnaire validated-8 (OAB-V8) both pre-and post-operatively. Further, all patients were clinically examined through urine culture, prostate-specific antigen (PSA), uroflowmetry, postvoiding residual urine volume (PVR), and ultrasound of the prostate and bladder.

resultsNone of the clinical examinations showed significant differences between the two groups. By questionnaire analysis, both groups showed similar significantly improved NIH-CPSI and IPSS scores after TUR-P. However, OAB symptoms were only significantly improved in patients without CPI.

conclusionsEven though TUR-P improves many of the LUT symptoms in patients with BPH, OAB symptoms with concomitant CPI are more challenging to manage. Identifying concomitant CPI in men with BPH can potentially help to guide post-operative decision-making following TUR-P.