Adult urologyPhysiologic Reactivity to a Laboratory Stress Task Among Men with Benign Prostatic Hyperplasia
Section snippets
Participants
The participants were recruited from a population of 119 patients with BPH involved at one site in the MTOPS clinical trial (detailed elsewhere).8 The MTOPS trial was a National Institutes of Health-funded multisite study investigating the efficacy of two drugs (finasteride and doxazosin) used to treat BPH. Finasteride is a 5-alpha-reductase inhibitor that interrupts the conversion of testosterone to dihydrotestosterone. Doxazosin is an alpha-blocker that inhibits the effects of epinephrine and
Sample Characteristics
Of the 119 MTOPS patients available for recruitment, 83 (70%) agreed to participate in the ancillary study. The distribution of participants across the MTOPS study groups closely approximated the proportions found in the entire sample. Most participants were retired, married, and had been educated beyond high school. The mean age of the sample was 68 years, and all participants were white. Table 1 presents the descriptive statistics for the key study variables.
Reactivity Measures
Patients taking doxazosin tended
Comment
Psychological stress has long been cited as a possible contributor to the exacerbation or persistence of urologic complaints.18 The present results associating DBP and cortisol reactivity with BPH disease factors are generally comparable to those of previous reports6, 7 and inferentially support a possible effect of psychological stress on BPH. Our study design makes it difficult to elucidate cause-and-effect interpretations of the associations between stress reactivity and BPH disease factors.
Conclusions
Physiologic reactivity to a standardized laboratory stressor was associated with objective and subjective BPH disease parameters, raising interesting possibilities regarding the relevance of stress in patients with BPH. Stress and other psychological factors might interact with anatomic and biologic factors to influence disease etiology. Stress could also be considered one of a number of factors with possible influence over the waxing and waning of BPH signs and symptoms.
Acknowledgment
To Margery Fearing, R.N., and Nathan Miller, B.S., for their assistance in conducting this study.
References (30)
- et al.
Etiology of benign prostate hyperplasia
Urol Clin North Am
(1995) Alpha blockage for the treatment of benign prostatic hyperplasia
Urol Clin North Am
(1995)- et al.
Autonomic nervous system overactivity in men with lower urinary tract symptoms secondary to benign prostatic hyperplasia
J Urol
(2005) - et al.
Salivary cortisol in psychoneuroendocrine research: recent developments and applications
Psychoneuroendocrinology
(1994) - et al.
Mechanisms in prostatitis/chronic pelvic pain syndrome
J Urol
(2004) - et al.
Insulin response to a short stress period
Psychoneuroendocrinology
(1989) - et al.
The role of psychological coronary risk factors in insulin and glucose metabolism
J Psychosom Res
(1994) Body fat distribution, insulin resistance, and metabolic disease
Nutrition
(1997)- et al.
Quality-of-life impact of lower urinary tract symptom severity: results from the Health Professionals Follow-up Study
Urology
(2002) - et al.
The concepts of stress and stress system disorders
JAMA
(1992)
Psychosocial stress and social support are associated with prostate-specific antigen levels in men: results from a community screening program
Psychosom Med
Stress, hostility, and disease parameters of benign prostatic hyperplasia
Psychosom Med
Clinical, anthropometric, metabolic and insulin profile of men with fast annual growth rates of benign prostatic hyperplasia
Blood Pressure
The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia
N Engl J Med
Correspondence between laboratory and ambulatory measures of cardiovascular reactivity: a multilevel modeling approach
Psychophysiology
Cited by (31)
EDITORIAL COMMENT
2021, UrologyShift Workers With Shift Work Disorder Have Worse Lower Urinary Tract Symptoms
2019, UrologyCitation Excerpt :Physiologic stress may also impact LUTS severity. Ullrich et al followed 83 men with BPH and found that under stressful conditions, greater increase in cortisol level compared to baseline was associated with greater bother (P <.05) and BPH Impact Index (P <.001) scores.26 Yet, there remains a dearth of research that demonstrates a direct mechanistic connection between low quality sleep and LUTS.
Metabolic syndrome and urinary disorders
2012, Progres en UrologieEffects of testosterone on the lower urinary tract go beyond the prostate: New insights, new treatment options
2011, Arab Journal of UrologyCitation Excerpt :Another recent study provided evidence that stress conditions could be associated with the development and aggravation of prostatic disease. It was found that body mass index, age and greater diastolic blood pressure reactivity were associated with a greater transition zone volume, greater total prostate gland volume, greater postvoid residual bladder volume, and more severe LUTS [17]. Inflammatory infiltrates are frequently found in and around nodules in BPH in men with symptomatic BPH [18].
Benign Prostatic Hyperplasia and Its Aetiologies
2009, European Urology, SupplementsCitation Excerpt :It has also been reported that catecholamine levels are high in essential hypertension. Previous studies have hypothesised that the sympathetic nervous system might have an effect on prostate growth by slowing down the apoptotic process [49,51,52]. In the last few years, the role of chronic inflammation in the pathogenesis of BPH has emerged (Table 1).
This study was funded by National Institutes of Health grant DK49971 awarded to K. J. Kreder.