Targeting Oxidative Stress in Urological Complications: Emerging Antioxidant Therapies for Benign Prostatic Hyperplasia and Liver Health Crosstalk

Benign Prostatic Hyperplasia (BPH) is a highly prevalent non-malignant urological disorder characterized by progressive enlargement of the prostate gland, primarily affecting aging males. This pathological growth results in lower urinary tract symptoms (LUTS), including urinary frequency, urgency, nocturia, weak stream, and incomplete bladder emptying, which significantly impair quality of life. While androgenic stimulation has traditionally been implicated in the pathogenesis of BPH, emerging evidence highlights oxidative stress (OS) as a critical driver of disease progression. Oxidative stress promotes cellular damage through excessive generation of reactive oxygen species (ROS), leading to lipid peroxidation, DNA fragmentation, mitochondrial dysfunction, and activation of inflammatory cascades that stimulate stromal and epithelial proliferation within the prostate. Moreover, increasing recognition is being given to the liver-prostate axis, with liver dysfunction — particularly non-alcoholic fatty liver disease (NAFLD) — contributing to systemic oxidative stress and inflammation that may exacerbate BPH pathogenesis. This review comprehensively evaluates the molecular mechanisms linking oxidative stress to BPH and liver dysfunction, while exploring emerging antioxidant therapeutic strategies. Natural phytochemicals, antioxidant vitamins, trace elements, and advanced nano-based delivery systems are critically appraised for their potential to modulate oxidative damage, improve prostate health, and restore liver-prostate homeostasis. Future research directions advocate for personalized antioxidant interventions, redox-based biomarkers, and translational studies to optimize BPH management. Keywords: Benign Prostatic Hyperplasia; Oxidative Stress; Antioxidant Therapy; Liver-Prostate Crosstalk; Phytochemicals