Materials and Methods
This study had a cross-sectional, retrospective design. Data were collected from between 2010 and 2019. The study was approved by the local ethics committee of our institution (approval number: E-19-2544). The inclusion criteria were the presence of indications for BPH surgery, such as symptomatic prostate enlargement, bladder stones, and contraindication of endoscopic treatment. The exclusion criteria were as follows: not attending follow-up or data to be retrospectively evaluated not being available in the hospital database, and pathological evaluation of the biopsy specimen revealing PCa, high-grade prostate intraepithelial neoplasia, or atypical small acinar proliferation. Our database included age, medications (5-alpha reductase inhibitors and or alpha blockers), PSA, free/total PSA ratio, PSA density (PSA/prostate volume), DRE findings, prostate volume (assessed with a transrectal ultrasound), serum neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, presence of MetS, and histopathological results after OP. Indications for transrectal ultrasound biopsy (TRUS-Bx) were the suspicion of malignancy in DRE and/or a serum PSA value of >4 ng/mL. The total prostate volume was computed by measuring the length, height and width of the gland on ultrasonography and multiplying the product by a coefficient of π/6 (0.52). The American Heart Association/National Heart Lung and Blood Institute criteria were used for the diagnosis of MetS.11 The presence of at least three of the following criteria was accepted to indicate MetS.
Waist circumference ≥ 102 cm
Triglyceride level ≥ 150 mg/dL or taking medicine
High-density lipoprotein level ˂ 40 mg/dL or taking medicine
Increased blood pressure (systolic pressure ≥ 130 mm Hg and diastolic blood pressure ≥ 85 mm Hg) or taking medicine
Fasting blood glucose ≥ 100 mg/dL or taking medicine
All procedures were performed using transvesical Freyer’s procedure. All surgical specimens were assessed by dedicated pathologists, and all cancers were graded according to the Gleason score (GS) based on the International Society of Urological Pathology 2005 and 2014 consensus. The patients were divided into two groups: The first group consisted of patients with a pathologically confirmed BPH and the second group comprised those with a pathological PCa diagnosis after OP.