Chronic periodontitis (CP) is an infectious disease resulting in inflammation within the supporting tissue of the teeth, progressive attachment, and bone loss. Recent data showed that CP was related to systemic diseases, such as cardiovascular disease, metabolic syndrome, and endothelial dysfunction. However, there have been scanty data about the relationship between lower urinary tract symptoms (LUTS)/ benign prostatic hyperplasia (BPH) and CP. This study was conducted to investigate the relationship between CP and LUTS/BPH.

A total of 208 men in their 40s and 50s who had received a health checkup were included. All of the data from the participants were collected prospectively. CP was defined as a 30 % increase in clinical attachment level (CAL)≥4mm of the total probed site. And, CAL was defined as the distance between the cementoenamel junction of the tooth and the deepest aspect of the pocket. All periodontal measurements were taken on 6 surfaces per tooth (mesiobuccal, mid-buccal, distobuccal, mesiolingual, mid-lingual, and distolingual) in all teeth except the third molars, using a Willams probe. All periodontal examinations were performed by a single periodontist who was blind urological data. LUTS/BPH was assessed using IPSS, transrectal ultrasonography, uroflowmetry, and postvoiding residual urine volume. Additionally, a full metabolic workup including testosterone was carried out. The Mann-Whitney U test and the multiple linear regression test were used for the evaluation of the relationships.

Median age, total prostate volume, IPSS total score, average flow rate, and maximal flow rate were 55.0 years old, 29.0 mL, 9.0, 9.0 mL/sec, and 20.5 mL/sec, respectively. In addition, the prevalence of CP was 26.7%. IPSS total, IPSS voiding, IPSS storage, and QoL score were significantly higher in patients with CP (median [interquartile range], P; IPSS total, 8.0 [5.0-13.5] vs. 12.0 [7.5-20.5], P=.004; IPSS voiding, 5.0 [2.0-9.0] vs. 8.5 [4.0-15.0], P=.002; IPSS storage, 3.0 [2.0-5.0] vs. 4.0 [3.0-6.0], P=.021; QoL, 2.0 [1.0-3.0] vs. 3.0 [2.0-4.0], P=.015). And, average flow rate was significantly lower in patients with CP (median [interquartile range] (mL/sec), P; 9.0 [8.0-13.0] vs. 8.0 [6.0-11.0], P=.042). After adjusting for age, testosterone, prostate volume, glucose, total cholesterol, and waist circumference, IPSS total and IPSS voiding score were significantly and positively related to CP (Estimated, Std. Error, P; IPSS total, 4.9498, 1.8573, .0093; IPSS voiding, 4.0077, 1.2835, .0025).

Our data suggest that LUTS/BPH is significantly related to CP. Metabolic syndrome, systemic inflammation, and direct dissemination of oral pathogen to prostate would be possible explanations for their relationships. For a better understanding of the pathophysiology of LUTS/BPH, further clinical and experimental studies would be needed.

LUTS/BPH is significantly related to CP.