Email this article Morphologic features of benign prostatic hyperplasia depending on the size of intravesical prostatic protrusion
- Authors: Krivoborodov G.G.1, Raksha A.P.1, Efremov N.S.1, Bolotov A.D.1, Sotnikova T.N.1
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Affiliations:
- Pirogov Russian National Research Medical University
- Issue: Vol 7, No 4 (2017)
- Pages: 17-23
- Section: Articles
- URL: https://bakhtiniada.ru/uroved/article/view/7698
- DOI: https://doi.org/10.17816/uroved7417-23
- ID: 7698
Cite item
Abstract
Relevance. Benign prostatic hyperplasia (BPH) is characterized by the presence of stromal and glandular hyperplasia in the periurethral and transitional zones. To describe the nature of intravesical growth of prostate tissue, an index of intravesical prostatic protrusion (IPP) was proposed. Clinically, men with an IPP measuring 10 mm or more are less likely to respond to α1-blocker therapy and 5α-reductase inhibitors. Thus, the description of the morphological features of the prostate depending on IPP grade is an actual issue.
Purpose: to identify features of the morphological structure of the IPP in men with BPH. Materials and methods. Surgical treatment of the clinical form of BPH was performed to 30 men. Patients were divided into 2 groups: 1st group had IPP less than 10 mm (n = 12) and the 2nd group had IPP 10 mm or more (n = 18). In this study we evaluated the age, prostate volume and the value of IPP. The material for morphological investigation was obtained with transurethral resection of the prostate from the IPP zone. For light-optical examination, the preparations were stained with hematoxylin-eosin for routine evaluation of the structure of the prostate gland and for Van Gieson to estimate the proportion of the muscular and fibrous components of the stroma. The quantification of structural indicators was carried out by means of the television image analyzer MEKOS-TS2 in an automatic mode.
Results: The groups were similar in age and prostate volume. In the group with IPP value of 10 mm or more, the proportion of the stromal component in the IPP zone was 77.5 ± 11.0%, the proportion of the glandular component was 22.5 ± 11.0%, respectively. In the group of men with IPP less than 10 mm, the proportion of the stromal component in the IPP zone was 96.0 ± 1.5%, the proportion of the glandular component was 4.0 ± 1.5%, respectively (p < 0.05). It was also found that with an increase in IPP there is a tendency to decrease the proportion of the muscular component of the stroma.
Conclusion: In men with BPH, with an increase in the value of intravesical prostatic protrusion in this zone, a relative increase in the proportion of the glandular component and a decrease in the proportion of the stromal component is proved, as well as a tendency to reduce the proportion of the muscular component of the stroma.
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##article.viewOnOriginalSite##About the authors
Grigorij G. Krivoborodov
Pirogov Russian National Research Medical University
Author for correspondence.
Email: dr.krivoborodov@yandex.ru
doctor of medical science, professor of department of urology and andrology
Russian Federation, MoscowAleksandr P. Raksha
Pirogov Russian National Research Medical University
Email: rakshadoc@yandex.ru
doctor of medical science, professor of department of pathological anatomy and clinical pathological anatomy
Russian Federation, MoscowNikolaj S. Efremov
Pirogov Russian National Research Medical University
Email: nefr@yandex.ru
candidate of medical science, associate professor of department of urology and andrology
Russian Federation, MoscowAndrej D. Bolotov
Pirogov Russian National Research Medical University
Email: adbolotov@gmail.com
postgraduate of department of urology and andrology
Russian Federation, MoscowTat'jana N. Sotnikova
Pirogov Russian National Research Medical University
Email: docsotnikova@mail.ru
assistant professor of department of pathological anatomy and clinical pathological anatomy
Russian Federation, MoscowReferences
- Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol. 1984;132(3):474-479. doi: 10.1016/s0022-5347(17)49698-4.
- McNeal JE. Origin and evolution of benign prostatic enlargement. Invest Urol. 1978;15(4):340-345 (https://www.ncbi.nlm.nih.gov/pubmed/75197).
- McNeal J. Pathology of benign prostatic hyperplasia. Insight into etiology. Urol Clin North Am. 1990;17(3):477-486.
- Roehrborn CG. Pathology of benign prostatic hyperplasia. Int J Impot Res. 2008;20(Suppl. 3): S11-S18. doi: 10.1038/ijir.2008.55.
- Ohnuki T, Kurokawa K, Katoh N, et al. Transrectal longitudinal ultrasonography of the prostate by electronic linear scanning. Hinyokika Kiyo. 1987;33(9):1385-1388 (In Japanese).
- Кривобородов Г.Г., Ефремов Н.С., Болотов А.Д. Ультразвуковые показатели предстательной железы, мочевого пузыря и данные урофлоуметрии в диагностике инфравезикальной обструкции у мужчин с доброкачественной гиперплазией предстательной железы // Урология. – 2017. – № 5. – C. 9–14. [Krivoborodov GG, Efremov NS, Bolotov AD. Ultrasound indicators of the prostate, urinary bladder and uroflowmetry parameters in the diagnosis of infravesical obstruction in men with benign prostatic hyperplasia. Urologiia. 2017;(5):9-14. (In Russ.)]. doi: https://dx.doi.org/10.18565/urology.2017.5.9-14.
- Kalkanli A, Tandogdu Z, Aydin M, et al. Intravesical Prostatic Protrusion: A Potential Marker of Alpha-blocker Treatment Success in Patients With Benign Prostatic Enlargement. Urology. 2016;88:161-165. doi: 10.1016/j.urology.2015.11.029.
- Park HY, Lee JY, Park SY, et al. Efficacy of alpha blocker treatment according to the degree of intravesical prostatic protrusion detected by transrectal ultrasonography in patients with benign prostatic hyperplasia. Korean J Urol. 2012;53(2):92-97. doi: 10.4111/kju.2012.53.2.92.
- Yoshida T, Kinoshita H, Yoshida K, et al. Intravesical Prostatic Protrusion as a Predicting Factor for the Adverse Clinical Outcome in Patients With Symptomatic Benign Prostatic Enlargement Treated With Dutasteride. Urology. 2016;91:154-157. doi: 10.1016/j.urology.2016.01.009.
- Урология. Российские клинические рекомендации / Под ред. Ю.Г. Аляева, П.В. Глыбочко, Д.Ю. Пушкаря. – М.: ГЭОТАР-Медиа, 2016. – 496 с. [Urologija. Rossijskie klinicheskie rekomendacii. Ed by Ju.G. Aljaev, P.V. Glybochko, D.Ju. Pushkar’. Moscow: GEOTAR-Media; 2016. 496 p. (In Russ.)]
- Isaacs J. Antagonistic effect of androgen on prostatic cell death. Prostate. 1984;5(5):545-557. doi: 10.1002/pros.2990050510.
- Andriole G, Bruchovsky N, Chung LW, et al. Dihydrotestosterone and the prostate: the scientific rationale for 5alpha-reductase inhibitors in the treatment of benign prostatic hyperplasia. J Urol. 2004;172(4 Pt 1):1399-1403. doi: 10.1097/01.ju.0000139539.94828.29.
- Russell DW, Wilson JD. Steroid 5 alpha-reductase: two genes/two enzymes. Ann Rev Biochem. 1994;63(1):25-61. doi: 10.1146/annurev.biochem.63.1.25.
- Carson C, Rittmaster RR. The role of dihydrotestosterone in benign prostatic hyperplasia. Urology. 2003;61(4 Suppl. 1):2-7. doi: 10.1016/s0090-4295(03)00045-1.
- Thigpen AE, Silver RI, Guileyardo JM, et al. Tissue distribution and ontogeny of steroid 5 alpha-reductase isozyme expression. J Clin Invest. 1993;92(2):903-910. doi: 10.1172/JCI116665.
- Hirayama K, Masui K, Hamada A, et al. Evaluation of Intravesical Prostatic Protrusion as a Predictor of Dutasteride-Resistant Lower Urinary Tract Symptoms/Benign Prostatic Enlargement With a High Likelihood of Surgical Intervention. Urology. 2015;86(3):565-569. doi: 10.1016/j.urology.2015.05.021.
- Zheng J, Pan J, Qin Y, et al. Role for intravesical prostatic protrusion in lower urinary tract symptom: a fluid structural interaction analysis study. BMC Urol. 2015;15(1):86. doi: 10.1186/s12894-015-0081-y.
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