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1999 Selected Abstracts from American Urological Association annual meeting

Asymptomatic Inflammation and/or Infection in Benign Prostatic Hyperplasia

JC Nickel; J Downey; ID Young; AH Boag; M Weir and P Kosev; Kingston, Canada (Presented by Dr, Nickel)
To determine the extent, pattern and clinical significance of asymptomatic histologic inflammation and latent infection in benign prostatic hyperplasia (BPH).
Methods and Patients:
Histologic sections from prospectively collected TURP specimens from 100 consecutive patients with a diagnosis of BPH, but no history or symptoms of prostatitis or infection were immunostained for leukocyte common antigen and assessed for inflammation by computerized image analysis. Inflammation were categorized as glandular, periglandular, stromal, or peri-urethral and inflammatory cell density graded semi-quantitatively. Correlations were sought between the volume, pattern and severity of inflammation, the results of bacteria culture of deep prostatic biopsies, indwelling catheters and PSA levels.
44% of the prostate specimens demonstrated bacterial growth (67% of catheterized; 28% of noncatheterized; 42% of patients were catheterized pre-op). 73% of the organisms cultured from the deep prostatic chips were potential uropathogens. Inflammation was identified in all cases but the tissue section surface area involved average only1.1% of the total specimen with peri-glandular inflammation being the predominant pattern (0.5%). There was no significant difference between any combination of inflammation pattern, volume of inflammation or grade in catheterized vs. non-catheterized patients (p=0.146) or culture positive (pathogenic or not) vs. culture negative cases (p=.06). Neither total PSA nor PSA density showed a significant correlation (p.05) with the amount, degree or distribution of inflammation and/or presence of bacteria.
Inflammation and bacterial colonization of the prostate is an extremely common finding in patients with BPH symptoms who do not have symptoms of prostatitis. No correlation was found between degree and pattern of inflammation, catheterization, presence of bacteria, serum PSA or PSA density.
Source: 1999 AUA Meeting

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