Context
Benign prostatic hyperplasia (BPH) is classically understood to be a disturbance in prostate homeostasis, but the underlying questions of how and why this disturbance occurs have yet to be answered definitively. An increasing body of evidence points to inflammation as a central component of the pathogenic process of BPH.
Objective
To review recent evidence regarding the association between histologic prostatic inflammation and the development and progression of BPH.
Evidence acquisition
This article is based primarily on material presented at a satellite symposium entitled, “Inflammation and Prostatic Diseases: From Bench to Bedside,” held during the 2015 annual meeting of the European Association of Urology in Madrid, Spain. Current data regarding the link between inflammation and BPH were reviewed.
Evidence synthesis
Evidence from a canine model of BPH and human prostate tissue has confirmed the presence of inflammation as a component of BPH. Pronounced inflammation was observed in dogs with hormonally induced prostatic hyperplasia. Longitudinal biopsy indicated that the cell-mediated and humoral immune response was preceded by hyperplasia. In surgically treated human BPH specimens, high-level inflammation was significantly associated with prostate enlargement and symptom evolution. Current opinion is that chronic inflammation and endocrine changes lead to disturbed homeostasis and tissue damage or, alternatively, that abnormal stem cell expansion and disturbed homeostasis lead to chronic inflammation and endocrine changes. Either way, a “vicious cycle” is initiated that leads to hyperplasia with fibrosis and changes in prostate tissue composition.
Conclusions
Increased insight into BPH pathogenesis indicates that restoring tissue endocrine metabolism and reducing chronic inflammation are prostate-specific targets for the treatment of BPH.
Patient summary
Increasing insight into benign prostatic hyperplasia (BPH) pathogenesis indicates that restoring tissue endocrine metabolism and reducing chronic inflammation are prostate-specific targets for treatment of BPH.
1 W Bushman. Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am. 2009;36:403-415 Crossref
2 B Chughtai, R Lee, A Te, S Kaplan. Role of inflammation in benign prostatic hyperplasia. Rev Urol. 2011;13:147-150
3 G Untergasser, S Madersbacher, P Berger. Benign prostatic hyperplasia: age-related tissue-remodeling. Exp Gerontol. 2005;40:121-128 Crossref
4 JC Nickel. Inflammation and benign prostatic hyperplasia. Urol Clin North Am. 2008;35:109-115 vii. Crossref
5 Y Bostanci, A Kazzazi, S Momtahen, J Laze, B Djavan. Correlation between benign prostatic hyperplasia and inflammation. Curr Opin Urol. 2013;23:5-10 Crossref
6 RO Roberts, DJ Jacobson, T Rhodes, GG Klee, MM Leiber, SJ Jacobsen. Serum sex hormones and measures of benign prostatic hyperplasia. Prostate. 2004;61:124-131 Crossref
7 Y Cai. Benign prostatic hyperplasia is a reawakened process of persistent Müllerian duct mesenchyme. BJU Int. 2001;87:177-182 Crossref
8 Y Xue, F Smedts, A Verhofstad, F Debruyne, J de la Rosette, J Schalken. Cell kinetics of prostate exocrine and neuroendocrine epithelium and their differential interrelationship: new perspectives. Prostate Suppl. 1998;8:62-73 Crossref
9 A Prajapati, S Gupta, B Mistry, S Gupta. Prostate stem cells in the development of benign prostate hyperplasia and prostate cancer: emerging role and concepts. Biomed Res Int. 2013;2013:107954
10 W Mahapokai, FJ Van Sluijs, JA Schalken. Models for studying benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2000;3:28-33
11 W Mahapokai, TS van den Ingh, F van Mil, et al. Immune response in hormonally-induced prostatic hyperplasia in the dog. Vet Immunol Immunopathol. 2001;78:297-303 Crossref
12 G Robert, A Descazeaud, N Nicolaïew, et al. Inflammation in prostatic tissue is associated with symptomatic BPH, IPSS and prostate volume! [abstract 1410]. J Urol. 2009;181(Suppl):504 Crossref
13 G Robert, A Descazeaud, Y Allory, F Vacherot, de la Taille. Should we investigate prostatic inflammation for the management of benign prostatic hyperplasia?. Eur Urol Suppl. 2009;8:879-886 Crossref
14 JD Adams, EJ Lien, X Wang. Saw palmetto, Serenoa repens, in the treatment of benign prostatic hyperplasia, mechanisms of action and reasons for its use. Pharm Pharmacol Int J. 2015;2:00007
1 W Bushman. Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am. 2009;36:403-415 Crossref
2 B Chughtai, R Lee, A Te, S Kaplan. Role of inflammation in benign prostatic hyperplasia. Rev Urol. 2011;13:147-150
3 G Untergasser, S Madersbacher, P Berger. Benign prostatic hyperplasia: age-related tissue-remodeling. Exp Gerontol. 2005;40:121-128 Crossref
4 JC Nickel. Inflammation and benign prostatic hyperplasia. Urol Clin North Am. 2008;35:109-115 vii. Crossref
5 Y Bostanci, A Kazzazi, S Momtahen, J Laze, B Djavan. Correlation between benign prostatic hyperplasia and inflammation. Curr Opin Urol. 2013;23:5-10 Crossref
6 RO Roberts, DJ Jacobson, T Rhodes, GG Klee, MM Leiber, SJ Jacobsen. Serum sex hormones and measures of benign prostatic hyperplasia. Prostate. 2004;61:124-131 Crossref
7 Y Cai. Benign prostatic hyperplasia is a reawakened process of persistent Müllerian duct mesenchyme. BJU Int. 2001;87:177-182 Crossref
8 Y Xue, F Smedts, A Verhofstad, F Debruyne, J de la Rosette, J Schalken. Cell kinetics of prostate exocrine and neuroendocrine epithelium and their differential interrelationship: new perspectives. Prostate Suppl. 1998;8:62-73 Crossref
9 A Prajapati, S Gupta, B Mistry, S Gupta. Prostate stem cells in the development of benign prostate hyperplasia and prostate cancer: emerging role and concepts. Biomed Res Int. 2013;2013:107954
10 W Mahapokai, FJ Van Sluijs, JA Schalken. Models for studying benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2000;3:28-33
11 W Mahapokai, TS van den Ingh, F van Mil, et al. Immune response in hormonally-induced prostatic hyperplasia in the dog. Vet Immunol Immunopathol. 2001;78:297-303 Crossref
12 G Robert, A Descazeaud, N Nicolaïew, et al. Inflammation in prostatic tissue is associated with symptomatic BPH, IPSS and prostate volume! [abstract 1410]. J Urol. 2009;181(Suppl):504 Crossref
13 G Robert, A Descazeaud, Y Allory, F Vacherot, de la Taille. Should we investigate prostatic inflammation for the management of benign prostatic hyperplasia?. Eur Urol Suppl. 2009;8:879-886 Crossref
14 JD Adams, EJ Lien, X Wang. Saw palmetto, Serenoa repens, in the treatment of benign prostatic hyperplasia, mechanisms of action and reasons for its use. Pharm Pharmacol Int J. 2015;2:00007
1 W Bushman. Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am. 2009;36:403-415 Crossref
2 B Chughtai, R Lee, A Te, S Kaplan. Role of inflammation in benign prostatic hyperplasia. Rev Urol. 2011;13:147-150
3 G Untergasser, S Madersbacher, P Berger. Benign prostatic hyperplasia: age-related tissue-remodeling. Exp Gerontol. 2005;40:121-128 Crossref
4 JC Nickel. Inflammation and benign prostatic hyperplasia. Urol Clin North Am. 2008;35:109-115 vii. Crossref
5 Y Bostanci, A Kazzazi, S Momtahen, J Laze, B Djavan. Correlation between benign prostatic hyperplasia and inflammation. Curr Opin Urol. 2013;23:5-10 Crossref
6 RO Roberts, DJ Jacobson, T Rhodes, GG Klee, MM Leiber, SJ Jacobsen. Serum sex hormones and measures of benign prostatic hyperplasia. Prostate. 2004;61:124-131 Crossref
7 Y Cai. Benign prostatic hyperplasia is a reawakened process of persistent Müllerian duct mesenchyme. BJU Int. 2001;87:177-182 Crossref
8 Y Xue, F Smedts, A Verhofstad, F Debruyne, J de la Rosette, J Schalken. Cell kinetics of prostate exocrine and neuroendocrine epithelium and their differential interrelationship: new perspectives. Prostate Suppl. 1998;8:62-73 Crossref
9 A Prajapati, S Gupta, B Mistry, S Gupta. Prostate stem cells in the development of benign prostate hyperplasia and prostate cancer: emerging role and concepts. Biomed Res Int. 2013;2013:107954
10 W Mahapokai, FJ Van Sluijs, JA Schalken. Models for studying benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2000;3:28-33
11 W Mahapokai, TS van den Ingh, F van Mil, et al. Immune response in hormonally-induced prostatic hyperplasia in the dog. Vet Immunol Immunopathol. 2001;78:297-303 Crossref
12 G Robert, A Descazeaud, N Nicolaïew, et al. Inflammation in prostatic tissue is associated with symptomatic BPH, IPSS and prostate volume! [abstract 1410]. J Urol. 2009;181(Suppl):504 Crossref
13 G Robert, A Descazeaud, Y Allory, F Vacherot, de la Taille. Should we investigate prostatic inflammation for the management of benign prostatic hyperplasia?. Eur Urol Suppl. 2009;8:879-886 Crossref
14 JD Adams, EJ Lien, X Wang. Saw palmetto, Serenoa repens, in the treatment of benign prostatic hyperplasia, mechanisms of action and reasons for its use. Pharm Pharmacol Int J. 2015;2:00007
1 W Bushman. Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am. 2009;36:403-415 Crossref
2 B Chughtai, R Lee, A Te, S Kaplan. Role of inflammation in benign prostatic hyperplasia. Rev Urol. 2011;13:147-150
3 G Untergasser, S Madersbacher, P Berger. Benign prostatic hyperplasia: age-related tissue-remodeling. Exp Gerontol. 2005;40:121-128 Crossref
4 JC Nickel. Inflammation and benign prostatic hyperplasia. Urol Clin North Am. 2008;35:109-115 vii. Crossref
5 Y Bostanci, A Kazzazi, S Momtahen, J Laze, B Djavan. Correlation between benign prostatic hyperplasia and inflammation. Curr Opin Urol. 2013;23:5-10 Crossref
6 RO Roberts, DJ Jacobson, T Rhodes, GG Klee, MM Leiber, SJ Jacobsen. Serum sex hormones and measures of benign prostatic hyperplasia. Prostate. 2004;61:124-131 Crossref
7 Y Cai. Benign prostatic hyperplasia is a reawakened process of persistent Müllerian duct mesenchyme. BJU Int. 2001;87:177-182 Crossref
8 Y Xue, F Smedts, A Verhofstad, F Debruyne, J de la Rosette, J Schalken. Cell kinetics of prostate exocrine and neuroendocrine epithelium and their differential interrelationship: new perspectives. Prostate Suppl. 1998;8:62-73 Crossref
9 A Prajapati, S Gupta, B Mistry, S Gupta. Prostate stem cells in the development of benign prostate hyperplasia and prostate cancer: emerging role and concepts. Biomed Res Int. 2013;2013:107954
10 W Mahapokai, FJ Van Sluijs, JA Schalken. Models for studying benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2000;3:28-33
11 W Mahapokai, TS van den Ingh, F van Mil, et al. Immune response in hormonally-induced prostatic hyperplasia in the dog. Vet Immunol Immunopathol. 2001;78:297-303 Crossref
12 G Robert, A Descazeaud, N Nicolaïew, et al. Inflammation in prostatic tissue is associated with symptomatic BPH, IPSS and prostate volume! [abstract 1410]. J Urol. 2009;181(Suppl):504 Crossref
13 G Robert, A Descazeaud, Y Allory, F Vacherot, de la Taille. Should we investigate prostatic inflammation for the management of benign prostatic hyperplasia?. Eur Urol Suppl. 2009;8:879-886 Crossref
14 JD Adams, EJ Lien, X Wang. Saw palmetto, Serenoa repens, in the treatment of benign prostatic hyperplasia, mechanisms of action and reasons for its use. Pharm Pharmacol Int J. 2015;2:00007
1 W Bushman. Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am. 2009;36:403-415 Crossref
2 B Chughtai, R Lee, A Te, S Kaplan. Role of inflammation in benign prostatic hyperplasia. Rev Urol. 2011;13:147-150
3 G Untergasser, S Madersbacher, P Berger. Benign prostatic hyperplasia: age-related tissue-remodeling. Exp Gerontol. 2005;40:121-128 Crossref
4 JC Nickel. Inflammation and benign prostatic hyperplasia. Urol Clin North Am. 2008;35:109-115 vii. Crossref
5 Y Bostanci, A Kazzazi, S Momtahen, J Laze, B Djavan. Correlation between benign prostatic hyperplasia and inflammation. Curr Opin Urol. 2013;23:5-10 Crossref
6 RO Roberts, DJ Jacobson, T Rhodes, GG Klee, MM Leiber, SJ Jacobsen. Serum sex hormones and measures of benign prostatic hyperplasia. Prostate. 2004;61:124-131 Crossref
7 Y Cai. Benign prostatic hyperplasia is a reawakened process of persistent Müllerian duct mesenchyme. BJU Int. 2001;87:177-182 Crossref
8 Y Xue, F Smedts, A Verhofstad, F Debruyne, J de la Rosette, J Schalken. Cell kinetics of prostate exocrine and neuroendocrine epithelium and their differential interrelationship: new perspectives. Prostate Suppl. 1998;8:62-73 Crossref
9 A Prajapati, S Gupta, B Mistry, S Gupta. Prostate stem cells in the development of benign prostate hyperplasia and prostate cancer: emerging role and concepts. Biomed Res Int. 2013;2013:107954
10 W Mahapokai, FJ Van Sluijs, JA Schalken. Models for studying benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2000;3:28-33
11 W Mahapokai, TS van den Ingh, F van Mil, et al. Immune response in hormonally-induced prostatic hyperplasia in the dog. Vet Immunol Immunopathol. 2001;78:297-303 Crossref
12 G Robert, A Descazeaud, N Nicolaïew, et al. Inflammation in prostatic tissue is associated with symptomatic BPH, IPSS and prostate volume! [abstract 1410]. J Urol. 2009;181(Suppl):504 Crossref
13 G Robert, A Descazeaud, Y Allory, F Vacherot, de la Taille. Should we investigate prostatic inflammation for the management of benign prostatic hyperplasia?. Eur Urol Suppl. 2009;8:879-886 Crossref
14 JD Adams, EJ Lien, X Wang. Saw palmetto, Serenoa repens, in the treatment of benign prostatic hyperplasia, mechanisms of action and reasons for its use. Pharm Pharmacol Int J. 2015;2:00007
1 W Bushman. Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am. 2009;36:403-415 Crossref
2 B Chughtai, R Lee, A Te, S Kaplan. Role of inflammation in benign prostatic hyperplasia. Rev Urol. 2011;13:147-150
3 G Untergasser, S Madersbacher, P Berger. Benign prostatic hyperplasia: age-related tissue-remodeling. Exp Gerontol. 2005;40:121-128 Crossref
4 JC Nickel. Inflammation and benign prostatic hyperplasia. Urol Clin North Am. 2008;35:109-115 vii. Crossref
5 Y Bostanci, A Kazzazi, S Momtahen, J Laze, B Djavan. Correlation between benign prostatic hyperplasia and inflammation. Curr Opin Urol. 2013;23:5-10 Crossref
6 RO Roberts, DJ Jacobson, T Rhodes, GG Klee, MM Leiber, SJ Jacobsen. Serum sex hormones and measures of benign prostatic hyperplasia. Prostate. 2004;61:124-131 Crossref
7 Y Cai. Benign prostatic hyperplasia is a reawakened process of persistent Müllerian duct mesenchyme. BJU Int. 2001;87:177-182 Crossref
8 Y Xue, F Smedts, A Verhofstad, F Debruyne, J de la Rosette, J Schalken. Cell kinetics of prostate exocrine and neuroendocrine epithelium and their differential interrelationship: new perspectives. Prostate Suppl. 1998;8:62-73 Crossref
9 A Prajapati, S Gupta, B Mistry, S Gupta. Prostate stem cells in the development of benign prostate hyperplasia and prostate cancer: emerging role and concepts. Biomed Res Int. 2013;2013:107954
10 W Mahapokai, FJ Van Sluijs, JA Schalken. Models for studying benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2000;3:28-33
11 W Mahapokai, TS van den Ingh, F van Mil, et al. Immune response in hormonally-induced prostatic hyperplasia in the dog. Vet Immunol Immunopathol. 2001;78:297-303 Crossref
12 G Robert, A Descazeaud, N Nicolaïew, et al. Inflammation in prostatic tissue is associated with symptomatic BPH, IPSS and prostate volume! [abstract 1410]. J Urol. 2009;181(Suppl):504 Crossref
13 G Robert, A Descazeaud, Y Allory, F Vacherot, de la Taille. Should we investigate prostatic inflammation for the management of benign prostatic hyperplasia?. Eur Urol Suppl. 2009;8:879-886 Crossref
14 JD Adams, EJ Lien, X Wang. Saw palmetto, Serenoa repens, in the treatment of benign prostatic hyperplasia, mechanisms of action and reasons for its use. Pharm Pharmacol Int J. 2015;2:00007
1 W Bushman. Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am. 2009;36:403-415 Crossref
2 B Chughtai, R Lee, A Te, S Kaplan. Role of inflammation in benign prostatic hyperplasia. Rev Urol. 2011;13:147-150
3 G Untergasser, S Madersbacher, P Berger. Benign prostatic hyperplasia: age-related tissue-remodeling. Exp Gerontol. 2005;40:121-128 Crossref
4 JC Nickel. Inflammation and benign prostatic hyperplasia. Urol Clin North Am. 2008;35:109-115 vii. Crossref
5 Y Bostanci, A Kazzazi, S Momtahen, J Laze, B Djavan. Correlation between benign prostatic hyperplasia and inflammation. Curr Opin Urol. 2013;23:5-10 Crossref
6 RO Roberts, DJ Jacobson, T Rhodes, GG Klee, MM Leiber, SJ Jacobsen. Serum sex hormones and measures of benign prostatic hyperplasia. Prostate. 2004;61:124-131 Crossref
7 Y Cai. Benign prostatic hyperplasia is a reawakened process of persistent Müllerian duct mesenchyme. BJU Int. 2001;87:177-182 Crossref
8 Y Xue, F Smedts, A Verhofstad, F Debruyne, J de la Rosette, J Schalken. Cell kinetics of prostate exocrine and neuroendocrine epithelium and their differential interrelationship: new perspectives. Prostate Suppl. 1998;8:62-73 Crossref
9 A Prajapati, S Gupta, B Mistry, S Gupta. Prostate stem cells in the development of benign prostate hyperplasia and prostate cancer: emerging role and concepts. Biomed Res Int. 2013;2013:107954
10 W Mahapokai, FJ Van Sluijs, JA Schalken. Models for studying benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2000;3:28-33
11 W Mahapokai, TS van den Ingh, F van Mil, et al. Immune response in hormonally-induced prostatic hyperplasia in the dog. Vet Immunol Immunopathol. 2001;78:297-303 Crossref
12 G Robert, A Descazeaud, N Nicolaïew, et al. Inflammation in prostatic tissue is associated with symptomatic BPH, IPSS and prostate volume! [abstract 1410]. J Urol. 2009;181(Suppl):504 Crossref
13 G Robert, A Descazeaud, Y Allory, F Vacherot, de la Taille. Should we investigate prostatic inflammation for the management of benign prostatic hyperplasia?. Eur Urol Suppl. 2009;8:879-886 Crossref
14 JD Adams, EJ Lien, X Wang. Saw palmetto, Serenoa repens, in the treatment of benign prostatic hyperplasia, mechanisms of action and reasons for its use. Pharm Pharmacol Int J. 2015;2:00007
1 W Bushman. Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am. 2009;36:403-415 Crossref
2 B Chughtai, R Lee, A Te, S Kaplan. Role of inflammation in benign prostatic hyperplasia. Rev Urol. 2011;13:147-150
3 G Untergasser, S Madersbacher, P Berger. Benign prostatic hyperplasia: age-related tissue-remodeling. Exp Gerontol. 2005;40:121-128 Crossref
4 JC Nickel. Inflammation and benign prostatic hyperplasia. Urol Clin North Am. 2008;35:109-115 vii. Crossref
5 Y Bostanci, A Kazzazi, S Momtahen, J Laze, B Djavan. Correlation between benign prostatic hyperplasia and inflammation. Curr Opin Urol. 2013;23:5-10 Crossref
6 RO Roberts, DJ Jacobson, T Rhodes, GG Klee, MM Leiber, SJ Jacobsen. Serum sex hormones and measures of benign prostatic hyperplasia. Prostate. 2004;61:124-131 Crossref
7 Y Cai. Benign prostatic hyperplasia is a reawakened process of persistent Müllerian duct mesenchyme. BJU Int. 2001;87:177-182 Crossref
8 Y Xue, F Smedts, A Verhofstad, F Debruyne, J de la Rosette, J Schalken. Cell kinetics of prostate exocrine and neuroendocrine epithelium and their differential interrelationship: new perspectives. Prostate Suppl. 1998;8:62-73 Crossref
9 A Prajapati, S Gupta, B Mistry, S Gupta. Prostate stem cells in the development of benign prostate hyperplasia and prostate cancer: emerging role and concepts. Biomed Res Int. 2013;2013:107954
10 W Mahapokai, FJ Van Sluijs, JA Schalken. Models for studying benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2000;3:28-33
11 W Mahapokai, TS van den Ingh, F van Mil, et al. Immune response in hormonally-induced prostatic hyperplasia in the dog. Vet Immunol Immunopathol. 2001;78:297-303 Crossref
12 G Robert, A Descazeaud, N Nicolaïew, et al. Inflammation in prostatic tissue is associated with symptomatic BPH, IPSS and prostate volume! [abstract 1410]. J Urol. 2009;181(Suppl):504 Crossref
13 G Robert, A Descazeaud, Y Allory, F Vacherot, de la Taille. Should we investigate prostatic inflammation for the management of benign prostatic hyperplasia?. Eur Urol Suppl. 2009;8:879-886 Crossref
14 JD Adams, EJ Lien, X Wang. Saw palmetto, Serenoa repens, in the treatment of benign prostatic hyperplasia, mechanisms of action and reasons for its use. Pharm Pharmacol Int J. 2015;2:00007
1 W Bushman. Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am. 2009;36:403-415 Crossref
2 B Chughtai, R Lee, A Te, S Kaplan. Role of inflammation in benign prostatic hyperplasia. Rev Urol. 2011;13:147-150
3 G Untergasser, S Madersbacher, P Berger. Benign prostatic hyperplasia: age-related tissue-remodeling. Exp Gerontol. 2005;40:121-128 Crossref
4 JC Nickel. Inflammation and benign prostatic hyperplasia. Urol Clin North Am. 2008;35:109-115 vii. Crossref
5 Y Bostanci, A Kazzazi, S Momtahen, J Laze, B Djavan. Correlation between benign prostatic hyperplasia and inflammation. Curr Opin Urol. 2013;23:5-10 Crossref
6 RO Roberts, DJ Jacobson, T Rhodes, GG Klee, MM Leiber, SJ Jacobsen. Serum sex hormones and measures of benign prostatic hyperplasia. Prostate. 2004;61:124-131 Crossref
7 Y Cai. Benign prostatic hyperplasia is a reawakened process of persistent Müllerian duct mesenchyme. BJU Int. 2001;87:177-182 Crossref
8 Y Xue, F Smedts, A Verhofstad, F Debruyne, J de la Rosette, J Schalken. Cell kinetics of prostate exocrine and neuroendocrine epithelium and their differential interrelationship: new perspectives. Prostate Suppl. 1998;8:62-73 Crossref
9 A Prajapati, S Gupta, B Mistry, S Gupta. Prostate stem cells in the development of benign prostate hyperplasia and prostate cancer: emerging role and concepts. Biomed Res Int. 2013;2013:107954
10 W Mahapokai, FJ Van Sluijs, JA Schalken. Models for studying benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2000;3:28-33
11 W Mahapokai, TS van den Ingh, F van Mil, et al. Immune response in hormonally-induced prostatic hyperplasia in the dog. Vet Immunol Immunopathol. 2001;78:297-303 Crossref
12 G Robert, A Descazeaud, N Nicolaïew, et al. Inflammation in prostatic tissue is associated with symptomatic BPH, IPSS and prostate volume! [abstract 1410]. J Urol. 2009;181(Suppl):504 Crossref
13 G Robert, A Descazeaud, Y Allory, F Vacherot, de la Taille. Should we investigate prostatic inflammation for the management of benign prostatic hyperplasia?. Eur Urol Suppl. 2009;8:879-886 Crossref
14 JD Adams, EJ Lien, X Wang. Saw palmetto, Serenoa repens, in the treatment of benign prostatic hyperplasia, mechanisms of action and reasons for its use. Pharm Pharmacol Int J. 2015;2:00007
1 W Bushman. Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am. 2009;36:403-415 Crossref
2 B Chughtai, R Lee, A Te, S Kaplan. Role of inflammation in benign prostatic hyperplasia. Rev Urol. 2011;13:147-150
3 G Untergasser, S Madersbacher, P Berger. Benign prostatic hyperplasia: age-related tissue-remodeling. Exp Gerontol. 2005;40:121-128 Crossref
4 JC Nickel. Inflammation and benign prostatic hyperplasia. Urol Clin North Am. 2008;35:109-115 vii. Crossref
5 Y Bostanci, A Kazzazi, S Momtahen, J Laze, B Djavan. Correlation between benign prostatic hyperplasia and inflammation. Curr Opin Urol. 2013;23:5-10 Crossref
6 RO Roberts, DJ Jacobson, T Rhodes, GG Klee, MM Leiber, SJ Jacobsen. Serum sex hormones and measures of benign prostatic hyperplasia. Prostate. 2004;61:124-131 Crossref
7 Y Cai. Benign prostatic hyperplasia is a reawakened process of persistent Müllerian duct mesenchyme. BJU Int. 2001;87:177-182 Crossref
8 Y Xue, F Smedts, A Verhofstad, F Debruyne, J de la Rosette, J Schalken. Cell kinetics of prostate exocrine and neuroendocrine epithelium and their differential interrelationship: new perspectives. Prostate Suppl. 1998;8:62-73 Crossref
9 A Prajapati, S Gupta, B Mistry, S Gupta. Prostate stem cells in the development of benign prostate hyperplasia and prostate cancer: emerging role and concepts. Biomed Res Int. 2013;2013:107954
10 W Mahapokai, FJ Van Sluijs, JA Schalken. Models for studying benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2000;3:28-33
11 W Mahapokai, TS van den Ingh, F van Mil, et al. Immune response in hormonally-induced prostatic hyperplasia in the dog. Vet Immunol Immunopathol. 2001;78:297-303 Crossref
12 G Robert, A Descazeaud, N Nicolaïew, et al. Inflammation in prostatic tissue is associated with symptomatic BPH, IPSS and prostate volume! [abstract 1410]. J Urol. 2009;181(Suppl):504 Crossref
13 G Robert, A Descazeaud, Y Allory, F Vacherot, de la Taille. Should we investigate prostatic inflammation for the management of benign prostatic hyperplasia?. Eur Urol Suppl. 2009;8:879-886 Crossref
14 JD Adams, EJ Lien, X Wang. Saw palmetto, Serenoa repens, in the treatment of benign prostatic hyperplasia, mechanisms of action and reasons for its use. Pharm Pharmacol Int J. 2015;2:00007
1 W Bushman. Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am. 2009;36:403-415 Crossref
2 B Chughtai, R Lee, A Te, S Kaplan. Role of inflammation in benign prostatic hyperplasia. Rev Urol. 2011;13:147-150
3 G Untergasser, S Madersbacher, P Berger. Benign prostatic hyperplasia: age-related tissue-remodeling. Exp Gerontol. 2005;40:121-128 Crossref
4 JC Nickel. Inflammation and benign prostatic hyperplasia. Urol Clin North Am. 2008;35:109-115 vii. Crossref
5 Y Bostanci, A Kazzazi, S Momtahen, J Laze, B Djavan. Correlation between benign prostatic hyperplasia and inflammation. Curr Opin Urol. 2013;23:5-10 Crossref
6 RO Roberts, DJ Jacobson, T Rhodes, GG Klee, MM Leiber, SJ Jacobsen. Serum sex hormones and measures of benign prostatic hyperplasia. Prostate. 2004;61:124-131 Crossref
7 Y Cai. Benign prostatic hyperplasia is a reawakened process of persistent Müllerian duct mesenchyme. BJU Int. 2001;87:177-182 Crossref
8 Y Xue, F Smedts, A Verhofstad, F Debruyne, J de la Rosette, J Schalken. Cell kinetics of prostate exocrine and neuroendocrine epithelium and their differential interrelationship: new perspectives. Prostate Suppl. 1998;8:62-73 Crossref
9 A Prajapati, S Gupta, B Mistry, S Gupta. Prostate stem cells in the development of benign prostate hyperplasia and prostate cancer: emerging role and concepts. Biomed Res Int. 2013;2013:107954
10 W Mahapokai, FJ Van Sluijs, JA Schalken. Models for studying benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2000;3:28-33
11 W Mahapokai, TS van den Ingh, F van Mil, et al. Immune response in hormonally-induced prostatic hyperplasia in the dog. Vet Immunol Immunopathol. 2001;78:297-303 Crossref
12 G Robert, A Descazeaud, N Nicolaïew, et al. Inflammation in prostatic tissue is associated with symptomatic BPH, IPSS and prostate volume! [abstract 1410]. J Urol. 2009;181(Suppl):504 Crossref
13 G Robert, A Descazeaud, Y Allory, F Vacherot, de la Taille. Should we investigate prostatic inflammation for the management of benign prostatic hyperplasia?. Eur Urol Suppl. 2009;8:879-886 Crossref
14 JD Adams, EJ Lien, X Wang. Saw palmetto, Serenoa repens, in the treatment of benign prostatic hyperplasia, mechanisms of action and reasons for its use. Pharm Pharmacol Int J. 2015;2:00007
1 W Bushman. Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am. 2009;36:403-415 Crossref
2 B Chughtai, R Lee, A Te, S Kaplan. Role of inflammation in benign prostatic hyperplasia. Rev Urol. 2011;13:147-150
3 G Untergasser, S Madersbacher, P Berger. Benign prostatic hyperplasia: age-related tissue-remodeling. Exp Gerontol. 2005;40:121-128 Crossref
4 JC Nickel. Inflammation and benign prostatic hyperplasia. Urol Clin North Am. 2008;35:109-115 vii. Crossref
5 Y Bostanci, A Kazzazi, S Momtahen, J Laze, B Djavan. Correlation between benign prostatic hyperplasia and inflammation. Curr Opin Urol. 2013;23:5-10 Crossref
6 RO Roberts, DJ Jacobson, T Rhodes, GG Klee, MM Leiber, SJ Jacobsen. Serum sex hormones and measures of benign prostatic hyperplasia. Prostate. 2004;61:124-131 Crossref
7 Y Cai. Benign prostatic hyperplasia is a reawakened process of persistent Müllerian duct mesenchyme. BJU Int. 2001;87:177-182 Crossref
8 Y Xue, F Smedts, A Verhofstad, F Debruyne, J de la Rosette, J Schalken. Cell kinetics of prostate exocrine and neuroendocrine epithelium and their differential interrelationship: new perspectives. Prostate Suppl. 1998;8:62-73 Crossref
9 A Prajapati, S Gupta, B Mistry, S Gupta. Prostate stem cells in the development of benign prostate hyperplasia and prostate cancer: emerging role and concepts. Biomed Res Int. 2013;2013:107954
10 W Mahapokai, FJ Van Sluijs, JA Schalken. Models for studying benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2000;3:28-33
11 W Mahapokai, TS van den Ingh, F van Mil, et al. Immune response in hormonally-induced prostatic hyperplasia in the dog. Vet Immunol Immunopathol. 2001;78:297-303 Crossref
12 G Robert, A Descazeaud, N Nicolaïew, et al. Inflammation in prostatic tissue is associated with symptomatic BPH, IPSS and prostate volume! [abstract 1410]. J Urol. 2009;181(Suppl):504 Crossref
13 G Robert, A Descazeaud, Y Allory, F Vacherot, de la Taille. Should we investigate prostatic inflammation for the management of benign prostatic hyperplasia?. Eur Urol Suppl. 2009;8:879-886 Crossref
14 JD Adams, EJ Lien, X Wang. Saw palmetto, Serenoa repens, in the treatment of benign prostatic hyperplasia, mechanisms of action and reasons for its use. Pharm Pharmacol Int J. 2015;2:00007
1 W Bushman. Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am. 2009;36:403-415 Crossref
2 B Chughtai, R Lee, A Te, S Kaplan. Role of inflammation in benign prostatic hyperplasia. Rev Urol. 2011;13:147-150
3 G Untergasser, S Madersbacher, P Berger. Benign prostatic hyperplasia: age-related tissue-remodeling. Exp Gerontol. 2005;40:121-128 Crossref
4 JC Nickel. Inflammation and benign prostatic hyperplasia. Urol Clin North Am. 2008;35:109-115 vii. Crossref
5 Y Bostanci, A Kazzazi, S Momtahen, J Laze, B Djavan. Correlation between benign prostatic hyperplasia and inflammation. Curr Opin Urol. 2013;23:5-10 Crossref
6 RO Roberts, DJ Jacobson, T Rhodes, GG Klee, MM Leiber, SJ Jacobsen. Serum sex hormones and measures of benign prostatic hyperplasia. Prostate. 2004;61:124-131 Crossref
7 Y Cai. Benign prostatic hyperplasia is a reawakened process of persistent Müllerian duct mesenchyme. BJU Int. 2001;87:177-182 Crossref
8 Y Xue, F Smedts, A Verhofstad, F Debruyne, J de la Rosette, J Schalken. Cell kinetics of prostate exocrine and neuroendocrine epithelium and their differential interrelationship: new perspectives. Prostate Suppl. 1998;8:62-73 Crossref
9 A Prajapati, S Gupta, B Mistry, S Gupta. Prostate stem cells in the development of benign prostate hyperplasia and prostate cancer: emerging role and concepts. Biomed Res Int. 2013;2013:107954
10 W Mahapokai, FJ Van Sluijs, JA Schalken. Models for studying benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2000;3:28-33
11 W Mahapokai, TS van den Ingh, F van Mil, et al. Immune response in hormonally-induced prostatic hyperplasia in the dog. Vet Immunol Immunopathol. 2001;78:297-303 Crossref
12 G Robert, A Descazeaud, N Nicolaïew, et al. Inflammation in prostatic tissue is associated with symptomatic BPH, IPSS and prostate volume! [abstract 1410]. J Urol. 2009;181(Suppl):504 Crossref
13 G Robert, A Descazeaud, Y Allory, F Vacherot, de la Taille. Should we investigate prostatic inflammation for the management of benign prostatic hyperplasia?. Eur Urol Suppl. 2009;8:879-886 Crossref
14 JD Adams, EJ Lien, X Wang. Saw palmetto, Serenoa repens, in the treatment of benign prostatic hyperplasia, mechanisms of action and reasons for its use. Pharm Pharmacol Int J. 2015;2:00007
1 W Bushman. Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am. 2009;36:403-415 Crossref
2 B Chughtai, R Lee, A Te, S Kaplan. Role of inflammation in benign prostatic hyperplasia. Rev Urol. 2011;13:147-150
3 G Untergasser, S Madersbacher, P Berger. Benign prostatic hyperplasia: age-related tissue-remodeling. Exp Gerontol. 2005;40:121-128 Crossref
4 JC Nickel. Inflammation and benign prostatic hyperplasia. Urol Clin North Am. 2008;35:109-115 vii. Crossref
5 Y Bostanci, A Kazzazi, S Momtahen, J Laze, B Djavan. Correlation between benign prostatic hyperplasia and inflammation. Curr Opin Urol. 2013;23:5-10 Crossref
6 RO Roberts, DJ Jacobson, T Rhodes, GG Klee, MM Leiber, SJ Jacobsen. Serum sex hormones and measures of benign prostatic hyperplasia. Prostate. 2004;61:124-131 Crossref
7 Y Cai. Benign prostatic hyperplasia is a reawakened process of persistent Müllerian duct mesenchyme. BJU Int. 2001;87:177-182 Crossref
8 Y Xue, F Smedts, A Verhofstad, F Debruyne, J de la Rosette, J Schalken. Cell kinetics of prostate exocrine and neuroendocrine epithelium and their differential interrelationship: new perspectives. Prostate Suppl. 1998;8:62-73 Crossref
9 A Prajapati, S Gupta, B Mistry, S Gupta. Prostate stem cells in the development of benign prostate hyperplasia and prostate cancer: emerging role and concepts. Biomed Res Int. 2013;2013:107954
10 W Mahapokai, FJ Van Sluijs, JA Schalken. Models for studying benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2000;3:28-33
11 W Mahapokai, TS van den Ingh, F van Mil, et al. Immune response in hormonally-induced prostatic hyperplasia in the dog. Vet Immunol Immunopathol. 2001;78:297-303 Crossref
12 G Robert, A Descazeaud, N Nicolaïew, et al. Inflammation in prostatic tissue is associated with symptomatic BPH, IPSS and prostate volume! [abstract 1410]. J Urol. 2009;181(Suppl):504 Crossref
13 G Robert, A Descazeaud, Y Allory, F Vacherot, de la Taille. Should we investigate prostatic inflammation for the management of benign prostatic hyperplasia?. Eur Urol Suppl. 2009;8:879-886 Crossref
14 JD Adams, EJ Lien, X Wang. Saw palmetto, Serenoa repens, in the treatment of benign prostatic hyperplasia, mechanisms of action and reasons for its use. Pharm Pharmacol Int J. 2015;2:00007
1 W Bushman. Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin North Am. 2009;36:403-415 Crossref
2 B Chughtai, R Lee, A Te, S Kaplan. Role of inflammation in benign prostatic hyperplasia. Rev Urol. 2011;13:147-150
3 G Untergasser, S Madersbacher, P Berger. Benign prostatic hyperplasia: age-related tissue-remodeling. Exp Gerontol. 2005;40:121-128 Crossref
4 JC Nickel. Inflammation and benign prostatic hyperplasia. Urol Clin North Am. 2008;35:109-115 vii. Crossref
5 Y Bostanci, A Kazzazi, S Momtahen, J Laze, B Djavan. Correlation between benign prostatic hyperplasia and inflammation. Curr Opin Urol. 2013;23:5-10 Crossref
6 RO Roberts, DJ Jacobson, T Rhodes, GG Klee, MM Leiber, SJ Jacobsen. Serum sex hormones and measures of benign prostatic hyperplasia. Prostate. 2004;61:124-131 Crossref
7 Y Cai. Benign prostatic hyperplasia is a reawakened process of persistent Müllerian duct mesenchyme. BJU Int. 2001;87:177-182 Crossref
8 Y Xue, F Smedts, A Verhofstad, F Debruyne, J de la Rosette, J Schalken. Cell kinetics of prostate exocrine and neuroendocrine epithelium and their differential interrelationship: new perspectives. Prostate Suppl. 1998;8:62-73 Crossref
9 A Prajapati, S Gupta, B Mistry, S Gupta. Prostate stem cells in the development of benign prostate hyperplasia and prostate cancer: emerging role and concepts. Biomed Res Int. 2013;2013:107954
10 W Mahapokai, FJ Van Sluijs, JA Schalken. Models for studying benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2000;3:28-33
11 W Mahapokai, TS van den Ingh, F van Mil, et al. Immune response in hormonally-induced prostatic hyperplasia in the dog. Vet Immunol Immunopathol. 2001;78:297-303 Crossref
12 G Robert, A Descazeaud, N Nicolaïew, et al. Inflammation in prostatic tissue is associated with symptomatic BPH, IPSS and prostate volume! [abstract 1410]. J Urol. 2009;181(Suppl):504 Crossref
13 G Robert, A Descazeaud, Y Allory, F Vacherot, de la Taille. Should we investigate prostatic inflammation for the management of benign prostatic hyperplasia?. Eur Urol Suppl. 2009;8:879-886 Crossref
14 JD Adams, EJ Lien, X Wang. Saw palmetto, Serenoa repens, in the treatment of benign prostatic hyperplasia, mechanisms of action and reasons for its use. Pharm Pharmacol Int J. 2015;2:00007
