Exercise Improves Symptoms of BPH

Men who are physically active are at lower risk for nocturia, according to a study led by a researcher at Loyola University Chicago Stritch School of Medicine.

Nocturia is the most common and bothersome lower urinary tract symptom (LUTS) in men and is frequently caused by benign prostatic hyperplasia (BPH). Other causes include overproduction of urine, low bladder capacity, and sleep disturbances. Nocturia increases with age and is estimated to occur in more than 50% of men aged 45 years and older (regardless of BPH status). It is also associated with a range of adverse health outcomes, including depression and poor sleep. While a number of studies have explored the effect of physical activity on BPH-related outcomes, nocturia has not been well studied in relation to lifestyle interventions separate from other LUTS.

The study by Kate Wolin, ScD, and colleauges was published this summer in Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine.

Wolin and her team analyzed data from a large, ongoing screening trial for which men aged 55 to 74 were eligible. The study included questions on BPH-related outcomes, including enlarged prostate, elevated PSA levels, and nocturia. Participants were also asked about physical activity and other lifestyle factors.

The study analysis included 28,404 men in the trial who had BPH outcomes before enrolling in the study (prevalent group) and 4710 men who had newly developed BPH (incident group).

Among men in the incident group, those who were physically active 1 or more hours per week were 13% less likely to report nocturia and 34% less likely to report severe nocturia than men who reported no physical activity. (Nocturia was defined as waking 2 or more times during the night to urinate; severe nocturia was defined as waking 3 or more times to urinate.) For men with and without additional BPH-related outcomes, the associations were similar, except for prevalent nocturia where the correlation was stronger for men without other BPH-related outcomes.

Several mechanism are proposed by which physical activity may protect against nocturia, including reducing body size, improving sleep, decreasing sympathetic nervous system activity, and lowering levels of systemic inflammation.

Future studies should explore physical activity as a potential symptom-management strategy, "with particular attention to the dose of physical activity necessary and the mechanisms that might underlie the association," the authors wrote.

References:

Wolin KY, Grubb RL, Pakpahan R, et al. Physical activity and benign prostatic hyperplasia-related outcomes and nocturia. Med Sci Sports Exerc. 2014;1. DOI: 10.1249/MSS.0000000000000444