Oxidative stress and hypoxia-induced inflammation contribute to bladder outlet obstruction (BOO) progression in men. This study investigated the roles of urine inflammatory and oxidative stress biomarkers in clinical benign prostatic hyperplasia (BPH) patients

This prospective study included 62 BPH patients (33 treated medically, 29 surgically) and 20 controls. Bladder wall thickness (BWT), symptom scores, uroflowmetry, and urine biomarker levels were measured at baseline and three months post-treatment.

Baseline levels of total antioxidant capacity (TAC), IL-1β, IL-6, and PGE2 were significantly elevated in BPH patients compared with controls. After treatment, successful outcomes were reported in 63.6% of the medical group and 86.2% of the surgical group, with improvements in symptom scores, quality of life, Qmax, and reductions in urinary F2-isoprostane, TAC, and IL-1β. In the medical group, baseline voiding efficiency (VE) was negatively correlated with levels of urinary IL-1β, IL-6, IL-8, and TNF-α, while BWT was positively correlated with TAC levels (Fig 1). Post-treatment, changes in International Prostate Symptom Score voiding subscores were positively correlated with changes in levels of IL-1β, IL-6, IL-8, and TNF-α in urine, and changes in VE were negatively correlated with these biomarkers. Moreover, changes in corrected maximal urinary flow rate were inversely associated with changes in levels of IL-1β and IL-8 in urine (Fig 2).

Urine inflammatory and oxidative biomarkers may serve as non-invasive indicators of oxidative stress in BPH patients, with significant correlations to clinical improvements, highlighting their potential for monitoring treatment efficacy.