INFLUENCE OF METABOLIC SYNDROME ON LOWER URINARY TRACT SYMPTOMS IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA

Lower urinary tract symptoms (LUTS) represent one of the most common clinical manifestations of benign prostatic hyperplasia (BPH) and significantly impair quality of life among aging men. Although benign prostatic enlargement has traditionally been considered the principal cause of LUTS, growing evidence indicates that systemic metabolic abnormalities also contribute substantially to the pathogenesis and progression of urinary symptoms. Metabolic syndrome, characterized by central obesity, impaired glucose metabolism, dyslipidemia, and arterial hypertension, has been increasingly recognized as an important factor influencing prostatic growth, chronic inflammation, autonomic nervous system activity, and bladder function. These metabolic alterations may accelerate the development of LUTS through endothelial dysfunction, oxidative stress, insulin resistance, and hormonal imbalance. The present study aimed to evaluate the influence of metabolic syndrome on lower urinary tract symptoms in patients with benign prostatic hyperplasia by analyzing clinical, anthropometric, and biochemical characteristics. The study included patients diagnosed with BPH with and without metabolic syndrome, together with an age-matched healthy control group. Clinical evaluation comprised body mass index, waist circumference, systolic and diastolic blood pressure, fasting plasma glucose, serum triglycerides, high-density lipoprotein cholesterol, prostate-specific antigen (PSA), prostate volume measured by transrectal ultrasonography, and the severity of lower urinary tract symptoms assessed using the International Prostate Symptom Score (IPSS). The findings demonstrated that patients with metabolic syndrome exhibited significantly more severe lower urinary tract symptoms, accompanied by increased prostate volume, higher PSA concentrations, and more pronounced metabolic abnormalities than patients without metabolic syndrome. Furthermore, the severity of LUTS was positively associated with obesity, hyperglycemia, hypertriglyceridemia, and enlarged prostate volume, whereas HDL cholesterol showed an inverse relationship with symptom severity. These findings suggest that metabolic syndrome contributes to the progression of lower urinary tract symptoms in patients with benign prostatic hyperplasia and should be considered during clinical evaluation and individualized therapeutic management.