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Abstract

We would like to thank Scarpa et al for elegant comment on our report: “Serum C-reactive protein levels are associated with residual urgency symptoms in patients with benign prostatic hyperplasia after medical treatment.” In accordance with previous reports, 1 Lu Z. Gao Y. Tan A. et al. Increased high-sensitivity C-reactive protein predicts a high risk of lower urinary tract symptoms in Chinese male: results from the Fangchenggang area male health and examination survey. Prostate. 2011 May 18; (Epub) Google Scholar , 2 St. Sauver J.L. Sarma A.V. Jacobson D.J. et al. Associations between C-reactive protein and benign prostatic hyperplasia/lower urinary tract symptom outcomes in a population based cohort. Am J Epidemiol. 2009; 169: 1281-1289 Crossref PubMed Scopus (56) Google Scholar our results suggest that serum C-reactive protein (CRP) levels have a significant association with storage symptoms, but not with voiding symptoms, in 408 men with lower urinary tract symptoms. The serum CRP levels decreased significantly after medical treatment for lower urinary tract symptoms (unpublished data). From these findings, we speculated that chronic inflammation has a greater association with storage symptoms than with voiding symptoms. Chronic inflammation of bladder might play a role in the occurrence of urgency, independent of prostate or voiding problems. The hypothesis is also supported by our results, which demonstrated that the serum CRP levels are not associated with the prostate volume, serum prostate-specific antigen level, maximal flow rate, or postvoid residual urine volume. An elevation in the serum CRP levels was also associated with overactive bladder and interstitial cystitis/bladder painful syndrome. 3 Chung S.D. Liu H.T. Lin H. et al. Elevation of serum C-reactive protein in patients with OAB and IC/BPS implies chronic inflammation in the urinary bladder. Neurourol Urodyn. 2011; 30: 417-420 Crossref PubMed Scopus (77) Google Scholar Editorial CommentUrologyVol. 78Issue 6PreviewThe merit of the present report and of a few others1-3 is that they draw attention to the strong connection between irritative voiding symptoms of patients with lower urinary tract symptoms and chronic inflammation of the urinary bladder and prostate, as denoted by elevated serum C-reactive protein levels (CRP), a nonspecific marker of systemic inflammation correlating with the circulating levels of the proinflammatory cytokine interleukin-6.4 Full-Text PDF