BPH A 28 IPSS BPH A

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1 DOI: /j.cnki.nja NJA National Journal of Andrology Zhonghua Nan Ke Xue Za Zhi http / /www. androl. cn Clinical Research TURP / BPH TURP TURP BPH 432 A BPH 30 B 55 C 31 D 28 IPSS % % % % IPSS A ± B ± C ± D ± A B P = P < IPSS A ± B ± C ± D ± P < IPSS P < BPH BPH BPH BPH R A LUTS in BPH patients with histological prostatitis before and after transurethral resection of the prostate HUANG Xiang-hua QIN Bin LIANG Yi-wen WU Qing-guo LI Chang-zan WEI Gang-shan JI Han-chu LIANG Yang-bing CHEN Hong-qiu GUAN Ting Department of Urology The Eighth Hospital Affiliated to Guangxi Medical University /Guigang People's Hospital Guigang Guangxi China Abstract Objective To investigate the effects of transurethral resection of the prostate TURP on lower urinary tract symptoms LUTS in patients with benign prostatic hyperplasia BPH complicated by histological prostatitis. Methods This study included 432 cases of BPH pathologically confirmed after TURP. Excluding those with LUTS-related factors before and after surgery and based on the international prostatitis histological classification of diagnostic criteria the remaining 144 cases were divided into groups A GXNSFA even-lyw@ 163. com

2 36 pure BPH n = 30 B mild inflammation n = 55 C moderate inflammation n = 31 and D severe inflammation n = 28. Each group was evaluated for LUTS by IPSS before and a month after surgery. Results A total of 399 cases 92. 4% were diagnosed as BPH with histological prostatitis % mild % moderate and % severe. The preoperative IPSS was ± in group A ± in B ± in C and ± in D with statistically significant differences among different groups P < except between A and B P = the postoperative IPSS was ± in A ± in B ± in C and ± in D with statistically significant differences among different groups P < and remarkably lower than the preoperative one P < Almost all the infiltrating inflammatory cells in BPH with histological prostatitis were lymphocytes. Conclusion BPH is mostly complicated with histological chronic prostatitis. The severity of LUTS is higher in BPH patients with histological prostatitis than in those without before and after TURP and positively correlated with the grade of inflammation. Those complicated with moderate or severe histological prostatitis should take medication for the management of LUTS. Natl J Androl Key words benign prostatic hyperplasia prostatitis lower urinary tract symptom transurethral resection of the prostate Supported by a grant from Natural Science Foundation of Guangxi Province 2010GXNSFA Received May accepted September benign prostatic hyperplasia 5 BPH 6 7 TURP 8 1 BPH CP 9 lower urinary tract symptoms LUTS 1. 3 BPH LUTS BPH LUTS 4 1 α 5α 5 CP BPH LUTS TURP BPH BPH CP HE CP IPSS PSA B IPSS PSA B BPH BPH CP BPH CP 2 1 D BPH α 5α 3 BPH chronic prostatitis CP TURP BPH A BPH BPH B BPH BPH C LUTS IPSS 2 BPH 1 1

3 SPSS A t A B 55 1-B Spearman P < CP BPH % % % % 144 C 31 1-C BPH D 28 1-D 1 HE 100 A B C D Figure 1. Pathological changes of the prostate tissue in different groups HE 100 A No inflammatory cell in the interstitium. B lymphocytes scattered in the interstitium. C lymphocytes gathered in the interstitium. D lymphoid nodule and the destroyed epithelial tissue of the gland IPSS IPSS F = P < P < IPSS F = LSD P P < Levene < F = P < Dunnett T 3 A ± B ± F = P = P = P < IPSS 1 2 Levene F = P = Spearman r = P <

4 38 1 IPSS x ± s Table 1. IPSS in different groups before and after surgery x ± s Group n Preoperation Postoperation Difference A ± ± a ± B ± ± ab ± C ± bc ± abc ± D ± bcd ± abcd ± a P < A b P < LUTS B c P < C d P < IPSS AUA LUTS 0 ~ 7 8 ~ ~ 35 BPH LUTS Nickel 12 a P < versus preoperation b P < versus Group A at BPH the same time c P < versus Group B at the same time d Spearman IPSS P < versus Group C at the same time. r = P < BPH BPH BPH LUTS TURP BPH LUTS IPSS BPH IPSS 2 IPSS IPSS Figure 2. Correlation of preoperative IPSS with the grade of inflammation F = P = IPSS ± BPH CP ± ± BPH 87. 5% BPH ~ 100% TURP LUTS 92. 4% 67. 4% BPH 21. 6% 11. 0% % 22. 4% 19. 3% T National Institute of Health NIH 11 BPH BPH CP Ⅳ asymptomatic inflammatory prostatitis AIP BPH

5 β. CP BPH BPH CP LUTS BPH TURP BPH LUTS LUTS LUTS 10 1 Blumenfeld W Tucci S Narayan P. Incidental lymphocytic prostatitis. Selective involvement with non-malignant glands. Surg Pathol Am J 2 Nickel JC True LD Krieger JN et al. Consensus development of a histopathological classification system for chronic prostatic inflammation. BJU Int peripheral and prostatic lymphocytes in patients with benign prostatic hyperplasia. J Urol Elist J. Effects of pollen extract preparation Prostat /Poltit on lower urinary tract symptoms in patients with chronic nonbacterial Sciarra A Mariotti G Salciccia S et al. Prostate growth and inflammation. J Steroid Biochem Mol Biol Seuver JL Jacobson DJ MeGree ME et al. Longitudinal association between prostatitis and development of benign prostatic hyperplasia. Urology Begley LA Kasina S MacDonald J et al. The inflammatory microenvironment of the aging prostate facilitates cellular proliferation and hypertrophy. Cytokine Gerstenbluth RE Steftel AD MacLennan GT et al. Distribution of chronic prostatitis in radical prostatectomy specimens with up-regulation of Bcl-2 in areas of inflammation. J Urol Nickel JC Downey J Young I et al. Asymptomatic inflammation and /or infection in benign prostatic hyperplasia. BJU Int Krieger JN Nyberg L Jr Nickle JC. NIH consensus definition and classification of prostatitis. JAMA Nickel JC. Prostatic inflammation in benign prostatic hyperplasia the third component Can J Urol Stein G Gessl A Kramer G et al. Phenotype and function of prostatitis /chronic pelvic pain syndrome A randomized doubleblind placebo-controlled study. Urology

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