Association between predictors of progression of benign prostatic hyperplasia and moderate-to-severe prostatitis-like symptoms: A propensity score-matched analysis

Jun Ho Lee; Yeon Won Park; Sin Woo Lee; Jae Duck Choi; Jung Yoon Kang; Tag Keun Yoo

doi:10.1016/j.prnil.2022.03.002

Association between predictors of progression of benign prostatic hyperplasia and moderate-to-severe prostatitis-like symptoms: A propensity score-matched analysis

Prostate Int. 2022 Jun;10(2):92-95. doi: 10.1016/j.prnil.2022.03.002. Epub 2022 Mar 11.

Authors

Jun Ho Lee¹, Yeon Won Park², Sin Woo Lee¹, Jae Duck Choi¹, Jung Yoon Kang¹, Tag Keun Yoo¹

Affiliations

¹ Department of Urology, Nowon Eulji Medical Center, Eulji University, Seoul, South Korea.
² Department of Urology, National Police Hospital, Seoul, South Korea.

Abstract

Background: We investigated the association between moderate-to-severe prostatitis-like symptoms and the predictors of benign prostatic hyperplasia (BPH) progression.

Methods: Men who underwent health checkups were analyzed. We classified symptoms as "moderate to severe" if the pain score according to the National Institutes of Health-Chronic Prostatitis Symptoms Index was ≥8 and predictors of the progression of BPH were defined as having a prostate-specific antigen (PSA) ≥1.6 ng/mL, total prostate volume (TPV) ≥31 mL, international prostate symptom score (IPSS) ≥20, and maximal flow rate (Q_max) <10.6 mL/s. A total of 8368 patients formed the cohort for propensity score matching, including 445 men with moderate-to-severe prostatitis-like symptoms and 5390 men with no symptoms; ultimately, however, the propensity score of these groups matched at a 1:2 ratio.

Results: After propensity matching, the two groups were evenly distributed with respect to age, International Index of Erectile Function-5 score, metabolic syndrome, and testosterone. The percentage of participants with ≥1 predictor for the progression of BPH, a TPV of ≥31 cm³, PSA levels of ≥1.6 ng/mL, Q_max <10.6 mL/s, and IPSS ≥20 were all greater in men with moderate-to-severe prostatitis-like symptoms. There were significant differences in the percentage of participants with ≥1 predictor for the progression of BPH (30.6% vs. 58.0%; p < 0.001), Q_max <10.6 mL/s (3.9% vs. 7.0%, p = 0.023), and IPSS ≥20 (9.6% vs. 44.7%, p < 0.001).

Conclusion: Moderate-to-severe prostatitis-like symptoms are significantly and independently associated with predictors of BPH progression.

Keywords: Benign prostatic hyperplasia; Chronic prostatitis/chronic pelvic pain syndrome; International prostate symptom score; Maximal flow rate.