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Background  Despite a worldwide common and progressive nature of benign prostate hyperplasia (BPH) in older men, no association has been observed between a causative pathogen and other etiology so far.    Methods  In this study, we investigated a causative association of  Trichomonas vaginalis,  a flagellate protozoan parasite, in 171 BPH cases presenting without symptoms of prostatitis at a surgical outpatient clinic in Kuwait. We detected  T. vaginalis  DNA by polymerase chain reaction (PCR) and  T. vaginalis  antigen by immunocytochemistry (ICC) in the prostate tissue of these cases. A total of 171 age-matched controls with no urinary tract symptoms were also included in the study. A detailed information regarding the sexual history and sexually transmitted infections (STIs) was enquired from all the enrolled subjects.    Results  We detected  T. vaginalis  DNA and  T. vaginalis  antigen in 42 (24.6 %) and 37 (21.6 %) of the 171 BPH cases respectively in their prostate tissue. Both these assays showed a very good agreement and statistically no significant difference in their sensitivities and specificities. A relatively higher seropositivity rate for antibodies to  T. vaginalis  was detected in BPH cases (53 of 171 cases, 31.0 %) than in the control group (26.9 %) [p: 0.19] and both were higher than in earlier reports but no significant association was observed between BPH and  T. vaginalis  serostatus. However, a greater proportion of seroreactive BPH cases had high IgG2 antibody absorbance score than in the control group (p:0.000). Furthermore, no significant association was observed between  T. vaginalis  seropositivity and presence of  T. vaginalis  DNA in the prostate tissue.    Conclusions  Our study documents  T. vaginalis  DNA and  T. vaginalis  antigen in 24.6 and 21.6 % respectively in the prostate tissue of the BPH cases. We also detected a relatively higher seropositivity rate for antibodies to  T. vaginalis  both in the BPH cases and in normal control group, 31 and 26.9 % respectively but no significant association was observed between BPH and  T. vaginalis  serostatus or presence of  T. vaginalis  DNA in the prostate tissue. Further epidemiological and case-controlled studies are needed to focus on local response to chronic asymptomatic retention of  T. vaginalis  in prostate tissue in the development of benign prostate hyperplasia.    Electronic supplementary material  The online version of this article (doi:10.1186/s12879-016-1843-1) contains supplementary material, which is available to authorized users.

Detection of Trichomonas vaginalis in prostate tissue and serostatus in patients with asymptomatic benign prostatic hyperplasia