Lower urinary tract symptom improvement after radical prostatectomy correlates with degree of prostatic inflammation.

Abstract:

OBJECTIVE:To determine if prostatic inflammation at the time of radical prostatectomy (RP) was associated with the International Prostate Symptom Score (IPSS). METHODS:We performed a proof of principle analytic case control study of patients who underwent RP between January 2005 and August 2008 for lower urinary tract symptoms (LUTS). We reviewed pathology slides of those who had a change of 4 points or greater, as measured by the IPSS and correlated inflammation with change in IPSS. Multivariate linear regression analyses were performed to determine the association of IPSS with degree of inflammation based on the number of inflammatory cells. RESULTS:Of 249 patients, 136 had complete data and 47 (18.8%) underwent pathologic review. The median change in IPSS for the study cohort was -7.0 points compared to +1.0 point for the control cohort. On univariate analysis, the average improvement in IPSS in patients with severe inflammation was (r = -6.02, 95% confidence interval [CI] -11.0 to -1.1, P = .018) after RP. On multivariate analysis, adjusting for age, body mass index (BMI), year of surgery, history of prostatitis, Gleason score, prostate-specific antigen (PSA), prostate weight, and nerve sparing status, only patients with severe prostatic inflammation had significant improvement in their IPSS (r = -5.93, 95% CI -10.81 to -1.04, P = .004). CONCLUSION:Prostatic inflammation measured in prostatectomy specimens is associated with worse baseline IPSS than matched cohorts. Specifically, severe inflammation is an independent predictor of IPSS improvement at 1 year after RP.

journal_name

Urology

journal_title

Urology

authors

Burris MB,Cathro HP,Kowalik CG,Jensen D,Culp SH,Steers WD,Krupski TL

doi

10.1016/j.urology.2013.07.080

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

186-90

issue

1

eissn

0090-4295

issn

1527-9995

pii

S0090-4295(13)01289-2

journal_volume

83

pub_type

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