Impact of COVID-19 vaccination on lower urinary tract (LUTS) in benign prostatic hyperplasia (BPH) patients

Purpose: Benign prostatic hyperplasia (BPH) is a common condition in men that can impact quality of life, especially in older age. BPH is nonmalignant prostate enlargement associated with lower urinary tract symptoms (LUTS). Various factors like aging, hormonal imbalance, and inflammation contribute to BPH, with androgen dysregulation playing a key role. The coronavirus disease 2019 (COVID-19) pandemic raised concerns about vaccine side effects, particularly in BPH patients experiencing LUTS. Research is ongoing to understand the impact of COVID-19 vaccination on LUTS in BPH patients. Materials and Methods: This prospective longitudinal study conducted at Sina Hospital in Tehran, Iran, from September 2022 to March 2023 enrolled 106 BPH patients receiving COVID-19 vaccines. Ultrasonography, total and free prostate specific antigen (PSA) test, and urine analysis were performed, and International Prostate Symptom Score questionnaires were completed before the vaccination. Vaccines included Oxford University/ AstraZeneca, Sinopharm, or Sputnik-V, with booster doses administered per manufacturer protocol. Three months post-booster shot, patients were re-evaluated with the same questionnaire. Data was analyzed using SPSS software. Results: Out of 3,591 individuals receiving COVID-19 vaccine,106 were eligible for analysis. The mean +/- standard deviation age on vaccination day was 65.4 +/- 11.74 years. Individuals receiving COVID-19 vaccines found no significant changes in PSA levels or prostate volume post-vaccination. Among urinary symptoms, urgency, dysuria, frequency, and hematuria rates increased significantly (p-value<0.05). Other symptoms showed no statistical differences. Conclusion: Our findings elucidate that urgency, dysuria, frequency, and hematuria may be exacerbated after COVID-19 vaccination in BPH patients.