TY - JOUR
T1 - Inflammation is a target of medical treatment for lower urinary tract symptoms associated with benign prostatic hyperplasia
AU - De Nunzio, Cosimo
AU - Salonia, Andrea
AU - Gacci, Mauro
AU - Ficarra, Vincenzo
N1 - Funding Information:
This work was supported by an educational grant by Pierre Fabre Pharma Italy.
Funding Information:
The authors are grateful to Ismar Healthcare NV who provided literature research and medical writing assistance; this was supported by an educational grant by Pierre Fabre Pharma Italy.
Funding Information:
C De Nunzio: consultant for Pierre-Fabre, Janssen and Astellas. V Ficarra: honoraria for speaking at symposia from Pierre Fabre and research grants from IDIPharma. M Gacci: company consultant, trial participation, fellowship, travel grant, receipt of grants/research supports for Astellas, Bayer, GSK, Ibsa, Konpharma, Lilly, Menarini, Pierre Fabre and Recordati. A Salonia: no conflict of interest.
Publisher Copyright:
© 2020, The Author(s).
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Purpose: To review the role of a persistent prostatic inflammatory status (PIS) in the development and progression of benign prostatic hyperplasia (BPH) associated with lower urinary tract symptoms (LUTS) and which medical therapies approved for LUTS/BPH may reduce persistent PIS. Methods: Literature search in PubMed up to July 2019. Results: The cause of histologically defined persistent PIS or chronic prostatic inflammation is multifactorial. It is evident in many men with LUTS/BPH, particularly in older men and in men with a large prostate volume or more severe (storage) LUTS. Additionally, persistent PIS is associated with an increased risk of acute urinary retention and symptom worsening. Of medical therapies approved for LUTS/BPH, the current evidence for a reduction of persistent PIS is greatest for the hexanic extract of Serenoa repens (HESr). This treatment relieves LUTS to the same extent as α1-adrenoceptor antagonists and short-term 5α-reductase inhibitors. Limited evidence is available on the effect of other mainstream LUTS/BPH treatments on persistent PIS. Conclusions: Persistent PIS plays a central role in both the development and progression of LUTS/BPH. In men with LUTS/BPH who have a high chance of harbouring persistent PIS, HESr will not only improve LUTS, but also reduce (underlying) inflammation. Well-designed clinical studies, with a good level of evidence, are required to better evaluate the impact of BPH/LUTS medical therapies on persistent PIS.
AB - Purpose: To review the role of a persistent prostatic inflammatory status (PIS) in the development and progression of benign prostatic hyperplasia (BPH) associated with lower urinary tract symptoms (LUTS) and which medical therapies approved for LUTS/BPH may reduce persistent PIS. Methods: Literature search in PubMed up to July 2019. Results: The cause of histologically defined persistent PIS or chronic prostatic inflammation is multifactorial. It is evident in many men with LUTS/BPH, particularly in older men and in men with a large prostate volume or more severe (storage) LUTS. Additionally, persistent PIS is associated with an increased risk of acute urinary retention and symptom worsening. Of medical therapies approved for LUTS/BPH, the current evidence for a reduction of persistent PIS is greatest for the hexanic extract of Serenoa repens (HESr). This treatment relieves LUTS to the same extent as α1-adrenoceptor antagonists and short-term 5α-reductase inhibitors. Limited evidence is available on the effect of other mainstream LUTS/BPH treatments on persistent PIS. Conclusions: Persistent PIS plays a central role in both the development and progression of LUTS/BPH. In men with LUTS/BPH who have a high chance of harbouring persistent PIS, HESr will not only improve LUTS, but also reduce (underlying) inflammation. Well-designed clinical studies, with a good level of evidence, are required to better evaluate the impact of BPH/LUTS medical therapies on persistent PIS.
KW - Medical therapy
KW - Phytotherapy
KW - Progression
KW - Prostatic hyperplasia
KW - Prostatic inflammation
KW - Serenoa repens
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U2 - 10.1007/s00345-020-03106-1
DO - 10.1007/s00345-020-03106-1
M3 - Review article
C2 - 32060633
AN - SCOPUS:85079554620
VL - 38
SP - 2771
EP - 2779
JO - World Journal of Urology
JF - World Journal of Urology
SN - 0724-4983
IS - 11
ER -