Correlation Between Benign Prostatic Hyperplasia and Inflammation

What Is the Meaning of Inflammation?

Inflammation is the body’s protective response against a variety of diseases. When foreign objects, bacteria, or harmful agents invade the body's cells, the immune system gets activated and releases inflammatory cells. Inflammation is not a condition but a symptom of many diseases like arthritis, Alzheimer's, etc. The inflammatory cells attack and trap the bacteria and foreign agents and initiate the body's healing process. When the body sends inflammatory cells due to sudden damage, the condition is known as acute inflammation. On the contrary, in chronic inflammation, the body continues sending inflammatory cells without outside danger. For example, people suffering from rheumatoid arthritis encounter inflammation that comes and goes because the body keeps on releasing inflammatory cells.

What Is Chronic Inflammation And BPH?

One might suggest that inflammation is an additional element in the pathophysiology of BPH. Moreover, androgen receptor signaling plays a role in tissue remodeling that is characteristic of the disease's later stages. Through the activation of CD4+ lymphocytes, prostate stromal cells play a crucial role in the generation of inflammatory reactions. Because hyperplastic nodules and chronic inflammatory infiltrates coexist in a large percentage of BPH tissues histologically, the link between BPH and intraprostatic inflammation was originally suggested. However, a negative association has been found between a decrease of the clinical state and the daily usage of non-steroidal anti-inflammatory medicines. Furthermore, a number of epidemiological studies demonstrated that acute or chronic inflammation has a role in the clinical development of symptoms associated with BPH.

What Is Benign Prostate Hyperplasia (BPH)?

Benign prostate hyperplasia is a common condition that affects elderly men. The condition is benign, so it does not spread to the other organs and remains confined to the gland. Two phases of growth are noticeable in the prostate gland. The first growth phase occurs at puberty, and the second begins at around 25. The prostate gland increases in size or doubles during the first phase and remains the same in the second phase. The prostate gland is located close to the neck of the urinary bladder. As the gland enlarges, it presses against the urethra, thickening the bladder wall. As a result, the bladder becomes weak and cannot function properly. When the urine remains in the urinary bladder, the condition is known as urinary retention, which makes it difficult for the patient to survive.

What Are the Signs and Symptoms of Benign Prostate Hyperplasia?

The prostate gland is located close to the neck of the urinary bladder. If the gland enlarges, the patient will encounter urinary tract problems. However, the severity of the condition does not depend on the size of the gland. Sometimes, people have enlarged prostates but do not experience any problems.

• Difficulty in starting the urine stream.

• Difficulty in emptying the bladder at once.

• Urinary urgency (a strong desire to urinate).

• Interrupted urine stream.

• Nocturia (increased urinary frequency at night).

• Urinary incontinence (urine leakage).

• The urine smells bad.

• Pain after sex or ejaculation.

How Is Benign Prostate Hyperplasia Treated?

A variety of methods can treat benign prostate hyperplasia. Some treatment options are:

1. Medications - Medications can treat benign prostate hyperplasia in the initial stages. However, surgical intervention is a major requirement if the condition progresses. The following medications are generally preferred.

Alpha-Blockers - The following alpha-blockers are commonly recommended in case of prostate enlargement:

• Terazosin.

• Doxazosin.

• Tamsulosin.

• Silodosin.

• Alfuzosin.

Phosphodiesterase-5 Inhibitors - PDE-5 inhibitors or phosphodiesterase inhibitors are not directly used to treat prostate enlargement. However, they can manage the erectile dysfunction that occurs due to prostate enlargement. The most commonly used PDE-5 inhibitor is Tadalafil.

Combination Drugs - If the drugs, as mentioned earlier, are ineffective, the doctor might recommend the combination of alpha-blockers and 5-alpha reductase inhibitors.

2. Minimally Invasive Procedures - The doctor might recommend minimally invasive procedures to the patient if the medications fail to work. The following procedures are usually recommended:

• Transurethral needle ablation (a procedure wherein the part of the prostate gland that appears enlarged is removed with the help of radio waves).

• High-intensity focused ultrasound (a procedure in which a probe or an ultrasound device is inserted into the rectum to view the prostate gland).

• Laser therapy (a procedure wherein a high-energy laser beam destroys the excessive tissue of the prostate gland).

3. Surgical Procedures - Surgical procedures are of great help when medicines and minimally invasive procedures do not provide relief from the symptoms of benign prostate hyperplasia. The following surgical procedures are usually done:

• Prostatectomy (a procedure in which the prostate gland is partly or completely removed via surgery.

• Transurethral incision of the prostate gland (a procedure wherein a tube known as a cystoscope is inserted into the urethra to visualize the prostate gland and the nearby structures).

• Transurethral resection of the prostate gland (a procedure wherein a resectoscope comprising a wire loop is inserted into the urethra to view the prostate gland and remove the prostate tissue in excess).

What Is the Correlation Between Benign Prostate Hyperplasia and Inflammation?

Chronic inflammation is associated with both cancer and benign prostate hyperplasia. The correlation between cancer and benign prostate hyperplasia is listed below:

• Inflammatory cells are frequently seen in benign prostate hyperplasia. However, the factors that activate the inflammatory pathway in the prostate gland are still unknown.

• Studies have reported that bacterial antigens, metabolic disorders, and chemical irritants are mainly responsible for inflammatory responses.

• Prostate inflammation leads to the accumulation of T lymphocytes, neutrophils, eosinophils, mast cells, and macrophages. These inflammatory agents stimulate the growth of nodules in benign prostate hyperplasia.

• It has been assumed that chronic inflammation, autoimmune diseases, and infections are responsible for creating a suitable environment for benign prostate hyperplasia.

• Benign prostate hyperplasia is a long-term and slowly progressive disease that presents with some amount of chronic inflammation.

What Is the Role of Inflammation in Benign Prostatic Hyperplasia?

Prostate inflammation refers to various hyperplastic changes that can occur in the prostate gland. Numerous growth factors or cytokines initiate an inflammatory mechanism. In addition, inflammation of the prostate gland serves as a crucial factor in regulating prostate growth and the severity of the symptoms. Nothing has been majorly known about the correlation between inflammation and benign prostatic hyperplasia.

Conclusion:

Inflammation is a protective response of the body's cells against a wide variety of diseases. Benign prostate hyperplasia of prostate enlargement is closely related to inflammation because numerous lymphocytes accumulate in the prostate gland. Initially, the patient might not experience any symptoms but present with urinary tract problems and inflammation later. The exact mechanism of inflammation in benign prostate hyperplasia is still under research. However, scientists have made some assumptions that explain the relationship between inflammation and prostate gland enlargement.