Relation between urethral elasticity and bladder outlet obstruction and histologic composition of the prostate in patients with benign prostatic hyperplasia
O. Ichiyanagi et al., Relation between urethral elasticity and bladder outlet obstruction and histologic composition of the prostate in patients with benign prostatic hyperplasia, UROLOGY, 53(6), 1999, pp. 1149-1153
Objectives. In benign prostatic hyperplasia (BPH), bladder outlet obstructi
on is caused by mechanical blockage resulting from an enlarged prostate, an
d by the increased tone of prostatic smooth muscle. In patients with obstru
ctive BPH, the prostatic urethra urodynamically corresponds to the flow-con
trolling zone (FCZ). We sought to investigate the relation between the obst
ruction and elastic properties of the FCZ and the histologic composition of
the prostate in symptomatic patients with BPH.
Methods. The grade of infravesical obstruction was classified according to
preoperative pressure-flow data from 30 men with symptomatic BPH, and the e
lastic properties of the FCZ were evaluated as the mean elastance, which wa
s calculated using the three-parameter model. The area densities of smooth
muscle, fibrous tissue, epithelium, and lumen were determined by quantitati
ve morphometry, using BPH tissue obtained by transurethral resection.
Results. The area density of smooth muscle had a negative correlation with
mean elastance (rho = -0.50, P <0.01), the linear passive urethral resistan
ce relation (rho = -0.45, P <0.05), and the group-specific urethral resista
nce factor (rho = -0.39, P <0.05). No other histologic element was correlat
ed with these variables.
Conclusions. Our results suggest that urethral elasticity and bladder outle
t obstruction grade are influenced by the relative content of smooth muscle
within the prostate in patients with BPH. UROLOGY 53: 1149-1153, 1999. (C)
1999, Elsevier Science Inc. All rights reserved.