Korean J Urol.  2008 Dec;49(12):1081-1086.

Relationship between Acute Urinary Retention and Intraprostatic Inflammation in Benign Prostatic Hyperplasia

• Ha JY
• Kwak DY
• Chang HS
• Park CH
• Kwon SY
• Kim CI

Abstract

PURPOSE: Acute or chronic prostatic inflammation exists to varying degrees in surgical specimens of prostates, extirpated for the treatment of benign prostatic hyperplasia(BPH). We investigated the relationship between acute urinary retention(AUR) and intraprostatic inflammation.
MATERIALS AND METHODS
Between January 1997 and December 2006, 221 patients underwent transurethral resection of the prostate(TURP) for the treatment of BPH. The patients were divided into 2 groups based on the indication for surgery; an AUR group and a lower urinary tract symptoms (LUTS) group. The area of acute inflammation, the extent, and the aggressiveness of chronic inflammation were classified into four grades. The grades of inflammation, prostate volume, age, serum prostate-specific antigen(PSA), and prior medical treatment were compared between the two groups. All specimens were reviewed by one pathologist.
RESULTS
The AUR group consisted of 106(47.9%) patients, and the LUTS group consisted of 115(52.1%) patients. There were no statistical differences between the two groups with respect to the mean values of the age, prostate size, and severity of chronic inflammation. There was a significant relationship between AUR and the areas of acute inflammation, and the extent of chronic inflammation(p=0.014 and p=0.003, respectively). The aggressiveness of chronic inflammation had no relationship with AUR (p=0.062). The serum PSA level was higher in the AUR group than the LUTS group(11.5 vs. 5.3ng/ml, respectively).
CONCLUSIONS
The association for AUR with acute and chronic inflammation was stronger than that which existed with prostate size. Thus intraprostatic inflammation is an important risk factor in AUR.

Keyword

Urinary retention; Prostatic hyperplasia; Prostatitis

MeSH Terms

Humans
Inflammation
Lower Urinary Tract Symptoms
Prostate
Prostatic Hyperplasia
Prostatitis
Risk Factors
Urinary Retention

Figure

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  Fig. 1. Extent of chronic inflammation was graded on a 4-point scale. (A) Grade 1: scattered inflammatory cell infiltrate within the stroma without lymphoid nodules (H&E, x200). (B) Grade 2: nonconfluent lymphoid nodules (H&E, x200). (C) Grade 3: large inflammatory areas with confluence of infiltrate (H&E, x200).

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  Fig. 2. Aggressiveness of chronic inflammation was graded on a 4-point scale. (A) Grade 1: contact between inflammatory cell infiltrate and glandular epithelium (however, minimal epithelium dissociation can be observed without disruption) (H&E, x400). (B) Grade 2: interstitial inflammatory infiltrate associated with a clear but limited (＜25% of the examined material) glandular epithelium disruption (H&E, x400). (C) Grade 3: glandular epithelium disruption on ＞25% of the examined material (H&E, x400).

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  Fig. 3. Bar chart shows extent of chronic inflammation based on chief complaint.

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  Fig. 4. Bar chart shows aggressiveness of chronic inflammation based on chief complaint.

Reference

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