Review Article

Prostatic inflammation: a potential treatment target for male LUTS due to benign prostatic obstruction

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Abstract

Background

The purpose of this narrative review is to evaluate the role of prostatic inflammation as a treatment target for lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO) and provide an update on the available therapies.

Methods

An extensive literature search was conducted for studies on established and investigational treatments with anti-inflammatory mechanism of action that has been assessed for the management of male LUTS due to BPO.

Results

Data on phosphodiesterase 5 inhibitors, nonsteroidal anti-inflammatory drugs, vitamin D3 receptor analogs, phytotherapy, statins, and lifestyle changes have been reviewed and analyzed. Preclinical evidence has shown the anti-inflammatory effect of these treatments on prostate. However, there is a wide variation in the degree of mature of each therapy. In addition, there are significant differences between the studies in terms of design, number of patients, and duration of follow-up.

Conclusions

Several drugs classes have been investigated for their impact on prostatic inflammation and improvement of male LUTS. The reviewed data support the rationale for use of agents that may alter and improve the inflammatory environment in the prostate in men with LUTS, but further high-quality long-term studies are required for the exact positioning of the new drugs in daily practice.

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Author information

Affiliations

  1. Urology Department Mezourlo, University Hospital of Larissa, Larissa, 41100, Greece

    • M. Samarinas
  2. Department of Urology, University of Florence, Viale Pieraccini 18, Florence, 50139, Italy

    • M. Gacci
  3. Department of Urology, Robotic and Miniinvasive Surgery Assistance Publique des Hopitaux de Paris CHU Mondor – Faculté de Médecine, 54 av du Mal de Lattre de Tassigny, Créteil, 94000, France

    • A. de la Taille
  4. Urology Department Mezourlo, University Hospital of Larissa, Larissa, 41100, Greece

    • S. Gravas

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Conflict of interest

A.d.l.T.: Astellas, Bouchara-Recordati, GSK, Pierre Fabre Medicament. S.G.: Astellas, Angelini Pharma Hellas, GSK, Lilly, Pierre Fabre Medicament. M.G.: Astellas, Bayer, GSK, Ibsa, Konpharma, Lilly, Pierre Fabre Medicament, Pfizer. M.S. declares no conflict of interest.

Corresponding author

Correspondence to S. Gravas.