Inflammation is a target of medical treatment for lower urinary tract symptoms associated with benign prostatic hyperplasia

被引:44
作者
De Nunzio, Cosimo [1 ]
Salonia, Andrea [2 ,3 ]
Gacci, Mauro [4 ]
Ficarra, Vincenzo [5 ]
机构
[1] Sapienza Univ Rome, St Andrea Hosp, Dept Urol, Rome, Italy
[2] Univ Vita Salute San Raffaele, Milan, Italy
[3] IRCCS Osped San Raffaele, Div Expt Oncol, Unit Urol, URI, Milan, Italy
[4] Univ Florence AOUC, Careggi Hosp, Minimally Invas & Robot Surg, Kidney Transplantat, Florence, Italy
[5] Univ Messina, Dept Human & Pediat Pathol Gaetano Barresi, Urol Sect, Piazza Pugliatti 1, I-98122 Messina, ME, Italy
关键词
Prostatic hyperplasia; Prostatic inflammation; Progression; Medical therapy; Phytotherapy; Serenoa repens; HEXANIC LIPIDOSTEROLIC EXTRACT; SERENOA-REPENS PERMIXON(R); METABOLIC SYNDROME; PROGRESSION; TAMSULOSIN; BPH; INTERLEUKIN-8; BIOMARKERS; PATHOGENESIS; FINASTERIDE;
D O I
10.1007/s00345-020-03106-1
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
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 alpha(1)-adrenoceptor antagonists and short-term 5 alpha-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.
引用
收藏
页码:2771 / 2779
页数:9
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