Ullrich PM et al. (2007) Physiologic reactivity to a laboratory stress task among men with benign prostatic hyperplasia. Urology 70: 487–492

The excessive growth of prostate tissue and increased contractility that occurs in benign prostatic hyperplasia (BPH) causes uncomfortable lower urinary tract symptoms. BPH arises because of subtle dysfunctions in the sympathetic nervous system and the hypothalamic–pituitary–gonadal axis, both of which are highly susceptible to psychological factors.

Ullrich et al. examined the relationship between psychological stress and BPH using measured responses to a standardized laboratory stress test in a group of 83 men who had been diagnosed with BPH. All were asked to perform a standardized laboratory stress task; changes in blood pressure, testosterone and cortisol levels were measured during the task. The degree of physiological response was then examined for potential correlation with the severity of BPH disease. This was assessed by measurements of prostate volume, postvoid residual urine volume, urine flow rate, self-reported lower urinary tract symptoms, and impact and bother scores.

Analysis revealed that increased diastolic blood pressure reactivity was associated with more-severe BPH symptoms, including a greater transition zone volume, a greater total prostate gland volume, greater postvoid residual urine volume, more-severe lower urinary tract symptoms and greater impact scores. Increased cortisol reactivity was associated with elevated bother and impact scores.

The authors conclude that higher physiological responses in a standardized laboratory stress test in men with BPH are associated with more-severe BPH disease. They suggest that this is further evidence that stress could be involved in the etiology of prostatic hyperplasia.