{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T21:59:22Z","timestamp":1775599162531,"version":"3.50.1"},"reference-count":26,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Life"],"abstract":"<jats:p>Background: Benign Prostatic Hyperplasia (BPH) causes Lower Urinary Tract Symptoms (LUTS), impairing quality of life (QoL). Transurethral Resection of the Prostate (TURP) is the gold-standard surgical treatment for Bladder Outlet Obstruction (BOO), but its effects on Autonomic Nervous System (ANS) function\u2014assessed via Heart Rate Variability (HRV)\u2014remains underexplored. To our knowledge, this is the first study to correlate HRV with specific LUTS domains pre- and post-TURP, establishing HRV as a potential biomarker for BPH management. Methods: In a prospective study, 242 men with BPH underwent TURP (2018\u20132024). Inclusion required age \u2265 50 years, International Prostate Symptom Score (IPSS) \u2265 8, and BOO evidence. HRV (Standard Deviation of Normal-to-Normal Intervals [SDNN], Low-Frequency\/High-Frequency [LF\/HF] ratio), IPSS, and QoL were assessed preoperatively and 3 months postoperatively. Paired t-tests, Pearson correlations, and multivariate regression (adjusted for age, Body Mass Index [BMI], prostate volume) were used (p &lt; 0.05). Results: HRV (SDNN) increased from 36.97 \u00b1 22.80 ms to 51.67 \u00b1 27.59 ms (p = 0.032), and LF\/HF ratio decreased from 1.63 \u00b1 1.60 to 0.73 \u00b1 0.52 (p = 0.028). IPSS fell from 18.5 \u00b1 6.2 to 8.3 \u00b1 4.1 (p &lt; 0.001), with improved voiding (p = 0.004) and storage (p = 0.002) subscores. QoL improved from 3.5 \u00b1 1.2 to 1.8 \u00b1 0.9 (p = 0.003). HRV correlated inversely with IPSS voiding (r = \u22120.42, p = 0.012; r = \u22120.38, p = 0.019 post-TURP) and storage subscores (r = \u22120.29, p = 0.045). Older patients (\u226565 years) and those with larger prostates (\u226550 mL) showed greater improvements. Conclusions: TURP enhances LUTS, QoL, and ANS function. HRV\u2019s correlation with LUTS suggests its biomarker potential, with possible cardiovascular benefits. Longitudinal studies are needed.<\/jats:p>","DOI":"10.3390\/life15101520","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T14:50:38Z","timestamp":1758898238000},"page":"1520","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Autonomic Modulation and Symptomatic Efficacy of Transurethral Resection of the Prostate in Benign Prostatic Hyperplasia"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6638-9897","authenticated-orcid":false,"given":"Kuan-Yu","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Urology, Chung Shan Medical University Hospital, Taichung 402, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun-Sheng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua 500, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3034-9548","authenticated-orcid":false,"given":"Min-Hsin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Urology, Chung Shan Medical University Hospital, Taichung 402, Taiwan"},{"name":"School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Hui","family":"Huang","sequence":"additional","affiliation":[{"name":"School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan"},{"name":"Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, Taichung 402, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2648-4691","authenticated-orcid":false,"given":"Sung-Lang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology, Chung Shan Medical University Hospital, Taichung 402, Taiwan"},{"name":"School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.1016\/j.juro.2011.01.074","article-title":"Update on AUA guideline on the management of benign prostatic hyperplasia","volume":"185","author":"McVary","year":"2011","journal-title":"J. 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