Introduction
Benign prostatic hyperplasia (BPH) is one of the most common diseases that affect men.1 The incidence of BPH in men aged 50-60 years is 50% and rises with increasing age.2According to the current European Association of Urology Guidelines, open prostatectomy (OP) or enucleation approaches of the prostate, such as holmium laser/bipolar are the first choice of surgical treatment in men with a substantially enlarged prostate (>80 mL).3
Prostate cancer (PCa) is the second most common type of cancer in men.4 The diagnosis of PCa is made by biopsy under the guidance of transrectal or transperineal ultrasonography for the histological confirmation of clinical cancer suspicion after digital rectal examination (DRE) and/or a high serum prostate-specific antigen (PSA) level.5 Incidental PCa (PCa), defined as a non-palpable tumor detected after BPH surgery, has been reported as a low-risk but unfavorable disease in most cases.6 The incidental PCa detection rates vary between 6.6 and 40.7% after OP.7-9 With the widespread use of PSA, more patients with BPH undergo a prostate biopsy and are offered treatments other than BPH surgery in case of a cancer diagnosis, which can reduce the risk of incidental tumors after treatment. Advances in reducing biopsy procedures may lead to an increase in incidental PCa detection after BPH surgery.7
There are many studies that have reported various factors, such as age, PSA and its derives, prostate volume, DRE, body mass index, and previous prostate biopsy results as predictors of incidental PCa after OP.7,10 However, to our knowledge, no research has evaluated the presence of metabolic syndrome (MetS) and inflammatory hematological parameters in the prediction of incidental PCa after OP. In this study, we evaluated the incidental PCa rate and predictive factors in patients who underwent OP with a pre-diagnosis of BPH in our clinic.