The Effect of Intraprostatic Chronic Inflammation on Benign Prostatic Hyperplasia Treatment

Purpose: Asymptomatic chronic inflammation of the prostate is a common finding in benign prostatic hyperplasia (BPH). We investigated how the chronic inflammation affects medical treatment for BPH. Materials and Methods: One pathologist reviewed the chronic inflammation of 82 BPH patients who underwent transrectal ultrasonography (TRUS)-guided needle biopsy. The extent of chronic inflammation was classified into 4 grades, categorized into two groups: the low-grade group and the high-grade group. We compared total, voiding, and storage International Prostate Symptom Score (IPSS) and quality of life (QoL) between the groups at baseline and 1, 3, 6, and 12 months after medical treatment for BPH. Results: There were no significant differences in total IPSS or QoL between the groups during the follow-up period. The low-grade group showed continuous improvement of storage symptoms until 12 months; however, the high-grade group showed improvement until 3 months. Maximal improvements of QoL were observed at 6 months in the high-grade group and at 3 months in the low-grade group. There was no episode of surgery in the low-grade group, but four patients in the high-grade group (9.1%) underwent surgical treatment due to acute urinary retention or insufficient therapeutic response. Conclusions: Although there was no statistical significance, improvements in IPSS were higher and lasted longer in the low-grade group. We might suggest medical treatment for intraprostatic chronic inflammation in BPH patients.