Is there a relationship between benign prostatic hyperplasia and symptomatic lumbar spinal stenosis in men? A retrospective comparative study

Despite extensive research into the pathophysiology of lumbar spinal stenosis (LSS), the precise reasons behind its increased symptomatic nature in women remain elusive. Notably, the physiological disparities between males and females, particularly concerning organ structures, such as the prostate, play a significant role. This study sought to explore potential correlations between symptomatic LSS and benign prostatic hyperplasia (BPH) exclusively in men. Conducted as a retrospective comparative analysis, the study encompassed individuals over the age of 60 with severe lumbar spinal stenosis seeking treatment for lower back and leg discomfort and undergoing lumbar magnetic resonance imaging (MRI) scans at relevant medical facilities. The assessment involved evaluating the functional status of the participants through the Oswestry disability index (ODI) and Visual Analog Scale (VAS), alongside determining the presence of BPH, and examining any history of medication utilization. A cohort of 49 patients were included in the study, with an average age of 70.7 ± 6.2 years. The median VAS pain score was 5 (25–75%: 3–8), while the mean ODI score stood at 43.5± 18.1. Notably, the ODI scores were worse in the BPH group (mean, 46.1 vs. 41.4). However, no statistically significant difference was observed between VAS and ODI scores (p = 0.834, p = 0.360) between patients with and without BPH. Similarly, no significant differences were noted in clinical scores between drug users and non-users (p = 0.868, p = 0.346). Statistically, the presence of BPH did not exhibit any discernible impact on the clinical prognosis of LSS. However, further comprehensive studies are imperative to elucidate the symptomatic variances between men with and without BPH.

Lumbar stenosis; Benign prostatic hyperplasia; Neurosteroids; Pain sensitivity; Allopregnanolone; Gender differences

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