Current Status of the Relationship Between Metabolic Syndrome and Lower Urinary Tract Symptoms

Although the exact nature of the association between metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) is still not completely understood, findings that men with metabolic alterations experience faster-developing LUTS or are more frequently candidates for benign prostatic enlargement (BPE) surgery support the hypothesis that metabolic and pathological derangements characterizing MetS can promote the development and progression of BPE and LUTS. The strong evidence that MetS is associated with larger prostate size supports a role for metabolic derangements in the development and progression of BPE. However, the relationship between MetS and LUTS is currently based on conflicting results. Most of the US and European population-based studies demonstrate a positive association between MetS and LUTS, but Asian studies often show opposite results. These findings indicate that ethnicity, diet and lifestyle could represent a central issue for the association between MetS and LUTS. Patient summary: The strong evidence that metabolic syndrome is associated with greater prostate size supports a role for metabolic derangements in the development and progression of benign prostatic enlargement. Ethnicity, diet, and lifestyle could represent central issues for the association between metabolic syndrome and lower urinary tract symptoms. (C) 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.