American Journal of Epidemiology Advance Access first published online on April 24, 2009
This version published online on May 8, 2009
American Journal of Epidemiology, doi:10.1093/aje/kwp084
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Invited Commentary: Lower Urinary Tract Symptoms and Inflammation—Weighing the Evidence
Correspondence to Dr. Stephen J. Freedland, Duke University Medical Center, Box 2626, Durham, NC 27710 (e-mail: steve.freedland{at}duke.edu).
Received for publication December 10, 2008. Accepted for publication January 9, 2009.
Lower urinary tract symptoms (LUTS) are a common condition, particularly among older men. The etiology of these symptoms is often obscure and not always clearly related to prostatic enlargement or benign prostatic hyperplasia. St. Sauver et al. (Am J Epidemiol. 2009;169(11):1281–1290) hypothesized that systemic inflammation may be associated with LUTS and benign prostatic hyperplasia. Using a well-defined cohort, they found that, in general, inflammation was not related to LUTS or to benign prostatic hyperplasia progression. However, men with the highest amount of systemic inflammation, as measured by C-reactive protein levels, were at increased risk of a rapid change in irritative voiding symptoms and decreased urinary flow but not obstructive voiding symptoms or prostate size. To what degree systemic inflammation relates to inflammation within the urinary system and specifically the bladder and/or prostate is unclear. Furthermore, to what degree inflammation within the urinary system contributes to LUTS is unclear. Given that clinical trials of antiinflammatory drugs for LUTS have been largely unsuccessful, the role of inflammation as a contributor to LUTS remains an interesting hypothesis that requires further study.
inflammation; prostate; urinary tract physiological phenomena
Abbreviations: BPH, benign prostatic hyperplasia; CRP, C-reactive protein; LUTS, lower urinary tract symptoms
The title has been corrected.