MORPHOMETRY OF BENIGN PROSTATIC HYPERPLASIA DURING ANDROGEN SUPPRESSIVE THERAPY - RELATIONSHIPS AMONG EPITHELIAL CONTENT, PSA DENSITY, AND CLINICAL OUTCOME

We performed light microscopic morphometry on prostate biopsies of 41 patients who underwent androgen suppressive therapy for 24 weeks with the luteinizing hormone releasing hormone (LHRH) agonist leuprolide de pot for symptomatic benign prostatic hyperplasia (BPH). Before treatme nt started, the prostates consisted of 88.4% stroma, 9.0% epithelium a nd 2.6% glandular lumen. After completion of therapy, the percentages were 94.7, 3.0 and 2.3, respectively. The absolute reductions of volum e were 27% for stroma, 77% for epithelium and 40% for lumen. Correlati ons between pretreatment parameters (epithelial content, stromal epith elial ratio and prostate specific antigen density (PSAD)) and the clin ical outcome parameters (prostate volume reduction, improvement in max imum flow rate, reduction of symptom score and reduction in outflow re sistance) were not statistically significant, indicating that the hist ological composition of BPH tissue or PSAD are poor parameters to pred ict differences in response for individual patients during hormonal th erapy for BPH. By comparing morphometry results of the core biopsies w ith morphometry performed on corresponding TURF tissue, it appeared th at the lumen content of the biopsies was somewhat underestimated.