The role of cigarette smoking in prostatic enlargement.

OBJECTIVE: To investigate the association between cigarette smoking and sex hormone concentrations in men with benign prostatic hyperplasia (BPH) and thus provide some understanding of the underlying mechanism of the effects of cigarette smoking on prostatic enlargement.

PATIENTS AND METHODS: The association between cigarette smoking and prostatic volume was investigated in 68 men with BPH (mean age 59 years, range 52-74) by assessing changes in serum levels of oestradiol, testosterone, dihydroepiandrosterone (DHEA) and dihydroepiandrosterone sulphate (DHEA-S). Possible enzymatic mechanisms in the prostate gland that might be affected by cigarette smoking were assessed.

RESULTS: The mean prostate volume was greater in non-smokers than smokers. Current cigarette smokers had significantly higher mean serum oestradiol levels than did the non-smokers (33.8 and 26.7 pg/mL, respectively, P < 0.01). Cigarette smoking was inversely but not significantly related to testosterone level. These differences persisted after adjusting for body mass index. There was no significant difference in serum DHEA and DHEA-S levels between smokers and non-smokers. There was a weak correlation between the degree of prostatic enlargement, the presence of obstructive symptoms and urinary flow rates.

CONCLUSION: These results indicate that cigarette smoking may affect the size of the enlarging prostate, but through indirect effects of smoking on factors provoking the development of BPH.