[Inflammation and benign prostatic hyperplasia: cause or consequence?].

INTRODUCTION AND OBJECTIVES: Although benign prostatic hyperplasia (BPH) is the most frequent disease in elderly men, only a few predictive factors have been clearly identified. Recently, chronic prostatic inflammation has emerged as one of them. This review aims at describing the scientific proof of a relationship between chronic prostatic inflammation and BPH. MATERIAL AND METHOD: Searching in the PubMed database identified clinical studies and basic research experiments in relation with the role of inflammation in BPH. RESULTS: Large clinical studies recently highlighted a relationship between chronic prostatic inflammation and prostate volume or urinary symptoms. Microscopic studies also found numerous inflammatory cells infiltrating BPH tissues. Immune cells are releasing cytokines and growth factors to modulate the immune response but evidences are also showing that they are promoting the epithelial and stromal prostatic cells growth. Moreover, prostatic cells by themselves are able to secrete inflammatory mediators and finally to stimulate their own growth. Once the vicious circle has started, it appears that feedback controls can be overwhelmed and that prostate volume progressively increases. CONCLUSION: BPH is a complex disease but chronic prostatic inflammation is one of the mechanisms leading to prostatic enlargement and urinary symptoms