Prostate volume measurement by multiparametric magnetic resonance and transrectal ultrasound: comparison with surgical specimen weight / Avaliação do volume prostático obtido por ressonância magnética multiparamétrica da próstata e ultrassonografia transretal comparado ao peso da peça cirúrgica

ABSTRACT Objective To assess accuracy of multiparametric magnetic resonance of the prostate to estimate gland volume, comparing the results with transrectal ultrasound and surgical specimen. Methods A retrospective study of 85 patients who underwent multiparametric magnetic resonance and transrectal ultrasound (for fusion image-guided biopsy) before radical prostatectomy. Prostate measurements were obtained from magnetic resonance axial and sagittal T2-weighted images and ultrasound; the prostate volume was determined using the ellipsoid formula. The results were compared with the surgical specimen weight. Maximum interval between multiparametric magnetic resonance imaging, transrectal ultrasound, and prostatectomy was 6 months. Results The prostate volume measured by multiparametric magnetic resonance imaging was 18-157cm3 (mean of 49.9cm3) and by transrectal ultrasound, 22-165cm3 (mean of 54.9cm3); the surgical specimen weight was 20-154g (mean of 48.6g), with no statistical differences. Based on the values obtained from imaging examinations, the prostate volume obtained was very close to the real prostatic weight, and the measures by multiparametric magnetic resonance were slightly more precise. Conclusion Prostate volume measured by multiparametric magnetic resonance imaging and transrectal ultrasound showed similar values, and excellent agreement with real prostate weight of the surgical specimens. Prostate volume measured by magnetic resonance has been increasingly used in the clinical practice, and its value enables appropriate therapeutic planning and control of patients.

RESUMO Objetivo Avaliar a acurácia da ressonância magnética multiparamétrica da próstata para estimativa do volume da glândula, comparando seus resultados com a ultrassonografia transretal e correlacionando com o volume obtido da peça cirúrgica. Métodos Estudo retrospectivo incluindo 85 pacientes submetidos à ressonância magnética e, posteriormente, à ultrassonografia transretal (para orientação de biópsia com fusão de imagens) e, a seguir, à prostatectomia radical. As dimensões prostáticas foram obtidas na ressonância a partir das imagens nos planos axial e sagital em sequências ponderadas em T2 e, assim como na ultrassonografia, o volume foi calculado a partir do método da elipsoide. Os valores foram comparados com o peso prostático pós-cirúrgico. O intervalo máximo entre a ressonância e ultrassonografia e prostatectomia foi de 6 meses. Resultados O volume prostático obtido por ressonância magnética foi de 18 a 157cm3(média de 49,9cm3); pela ultrassonografia transretal, foi de 22 a 165cm3(média de 54,9cm3); e o peso da peça cirúrgica foi de 20 a 154g (média de 48,6g), sem diferenças estatísticas. A partir do valor obtido por esses métodos de imagem, provou-se que o volume prostático obtido aproximou-se bastante do peso real da próstata, com discreta maior precisão das medidas obtidas por ressonância magnética multiparamétrica. Conclusão As medidas do volume prostático adquiridas pela ressonância magnética e pela ultrassonografia transretal são semelhantes entre si, com excelente concordância com os pesos reais das próstatas obtidos das peças cirúrgicas. A avaliação desse dado, a partir da ressonância, método cada vez mais utilizado na prática clínica, permite o adequado planejamento terapêutico e o controle dos pacientes.

Correlation between prostate volume and prostate-specific antigen in patients diagnosed with benign prostatic hyperplasia

Background: Prostate volume (PV) and serum prostate specific antigen (PSA) have been consistently linked to benign prostatic hyperplasia (BPH) disease progression especially when prostate volumes are >30mls and PSA>1.5ng/ml. PSA is produced by the ductal epithelial cells of the prostate. Understanding the natural history of prostate diseases requires knowledge of prostate volume and PSA. Objective: We set out to determine the correlation between prostate volume and PSA in our cohorts of men diagnosed with BPH. Methodology: Information from the case notes of 120 patients were retrieved including history, physical examination and result of relevant investigations. Data collated were analyzed using the statistical package for social sciences (SPSS) version 20.0 software. Results: Mean age of the patients was 64.95±9.22 years while mean PV and PSA were respectively 70.20±52.01mls and 4.58±3.32ng/ml. Correlation between PV and PSA was statistically significant: r=.407, P value was set at <.05. Conclusion: We concluded that PV and serum PSA levels have a direct relationship

Histological analysis of rat prostate under exogenous testosterone and low dose of oral selenium administration / Histología de la próstata de ratón influenciada por testosterona y la dosis supranutricional de selenio / Histologia da próstata de rato sob influência de testosterona exógena e dose supranutricional de selênio

Objective: to verify selenium effectiveness in maintenance of prostate tissue architecture. Method: experimental study using 20 adult 90-day-old male rats divided into the following groups: TG, 05 animals that received injectable testosterone; TSG, 05 animals that received injectable testosterone and weekly doses of selenium by gavage; CG1, 05 intact animals; CG2, 05 animals that received saline injection and saline by gavage. Results: characteristic architecture was found in tissue samples from animals of CG with cubic/prismatic secretory epithelium surrounded by fibro-muscular stroma. Animals of TG showed an increase in prostatic epithelium height, increase in the number of blood vessels in stroma and presence of proliferative lesions. Proliferative lesions were also found in tissue samples from animals of TSG, besides having improve in epithelial height, as seen in TG. Conclusion: it is concluded that selenium at this concentration has no effectiveness in modulating morphology of prostatic tissue of adult rats.(AU)

Objetivo: verificar la eficacia del selenio en mantener la morfología tisular. Método: estudio experimental, utilizando 20 ratones machos adultos (5 animales/grupo), divididos en: TG, recibieron testosterona inyectable; TSG, recibieron testosterona inyectable y dosis semanales de selenio por gavado; CG1, animales intactos; CG2, recibieron solución salina inyectable y por gavado. Resultados: una arquitectura característica fue encontrada en las muestras tisulares de los animales del CG, con epitelio cúbico/prismático envuelto por estroma fibro-muscular. En los animales del TG la próstata presentó un epitelio con células más altas, un aparente aumento en el número de vasos sanguíneos estromais, además de la presencia de lesiones proliferativas. También se encontraron lesiones proliferativas en las muestras tisulares de los animales del TSG, además de presentar mayor altura del epitelio, como vistas en TG. Conclusión: se concluye así que el Selenio, en esta concentración, parece no ser eficaz en la protección contra las modificaciones promovidas por la administración de T exógena en ratas adultas.(AU)

Objetivo: verificar a eficácia do selênio na manutenção da morfologia tecidual prostática. Métodos: estudo experimental, utilizando 20 ratos machos adultos, divididos em: TG, 05 animais que receberam testosterona injetável; TSG, 05 animais que receberam testosterona injetável e doses semanais de selênio por gavagem; CG1, 05 animais intactos; CG2, com 05 animais que receberam solução salina injetável e por gavagem. Resultados: uma arquitetura característica foi encontrada nas amostras teciduais dos animais do CG, com epitélio cúbico/prismático envolvido por estroma fibro-muscular. Nos animais do TG a próstata apresentou um epitélio com células mais altas, um aparente aumento no número de vasos sanguíneos no estroma, além da presença de lesões proliferativas. Também foram encontradas lesões proliferativas nas amostras teciduais dos animais do TSG, além de apresentarem maior altura do epitélio, como vistas no TG. Conclusão: conclui-se assim, que o Selênio, nesta concentração, parece não ser eficaz na proteção contra as modificações promovidas pela administração de T exógena em ratos adultos.(AU)

Demostración histoquímica de mucina para el diagnóstico diferencial de las lesiones benignas y malignas de próstata / Mucin histochemistry demonstration for the differential diagnosis of prostate benign and malign lesions

Se realizó un estudio analítico y comparativo de 553 biopsias realizadas en el Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba en el período 2014-2015, con vistas a valorar la utilidad de las coloraciones histoquímicas de mucina: PAS, azul alcian (2,5 pH) y PAS-azul alcian, para diferenciar las lesiones benignas y malignas de la próstata. En la serie se obtuvo 98,4 por ciento de hiperplasias benignas positivas con el PAS y ninguna de ellas con el azul alcian, mientras que 50,9 por ciento de todos los carcinomas resultaron positivos con esta última; por el contrario, para los carcinomas bien diferenciados, la positividad con el azul alcian resultó ser de 96,3 por ciento y solo de 3,6 por ciento con el PAS. Se concluye que las coloraciones histoquímicas de mucina pueden ser usadas como herramientas para distinguir el adenocarcinoma bien diferenciado de la hiperplasia prostática

A comparative analytical study of 553 biopsies was carried out in "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba during 2014-2015, aimed at valuating the usefulness of mucin histochemistry stains: PAS, alcian blue (2.5 pH) and PAS-alcian blue, to differentiate the prostate benign and malign lesions. In the series, 98.4 percent of positive benign hyperplasias with PAS was obtained and none of them with alcian blue, while 50.9 percen of all carcinomas were positive with the latter; on the contrary, for the well differentiated carcinomas, the positivity with alcian blue was 96.3 percen and just 3.6 percen with PAS. It was concluded that mucin histochemistry stains can be used as tools to distinguish the well differentiated adenocarcinoma from the prostatic hyperplasia

Análise histoquímica das glândulas anexas do aparelho reprodutor do macho de paca (Cuniculus paca) / Histochemical analysis of the accessory glands of male paca (Cuniculus paca)

Paca is a wild rodent typical of the tropical region. In order to study this species with focus on the proper management and preservation, this study aims to characterize the histochemistry of the accessory glands of the reproductive tract of the male paca. For this purpose, histological sections were stained with Periodic Acid-Schiff (PAS), Alcian Blue (AB), PAS + AB e PAS + Amilase. In the histochemical reaction of the bulbouretral gland was found that the epithelium produces secretion rich in neutral and acid glycoproteins, glycosaminoglycans, and in some regions produces more than one type of secretion. The epithelium did not contain any glycogen. In the vesicular gland the epithelium had bush border stained by neutral glycoproteins, but no acid glycoproteins, glycogen or glycosaminoglycan. The coagulating gland showed small amount of neutral glycoproteins in the brush border of the epithelium, without glycogen. It is concludes that the accessory glands of paca have histochemical characteristics that share some similarity with other species of the Order Rodentia, with some glands with neutral and acid glycoproteins, mainly in the epithelium of the bulbouretral gland and in the brush border of the other glands.

A paca (Cuniculus paca) é um roedor típico de regiões tropicais. Com a finalidade de estudar esta espécie selvagem para manejo adequado e sua preservação, objetivou-se neste trabalho caracterizar a histoquímica das glândulas anexas do trato reprodutor do macho da paca. Para este fim, cortes histológicos dessas glândulas foram submetidas às reações histoquímicas com Ácido Periódico de Schiff (PAS), Alcian blue (AB), PAS. + AB. e PAS + Amilase. Na glândula bulbouretral foi constatado que o epitélio produz secreção rica em glicoproteínas neutras e ácidas, glicosaminoglicanas, e em algumas regiões produz mais de um tipo de secreção. Não foi observada a presença de glicogênio no epitélio. Na glândula vesicular, seu epitélio em borda em escova corou-se por glicoproteínas neutras e também por substância de composição desconhecida, não contendo glicoproteínas ácidas, glicogênio ou glicosaminoglicanas. Verificou-se presença de pequena quantidade de glicoproteínas ácidas e neutras na próstata, em especial na mucosa, além de glicoproteínas ácidas carboxiladas e sulfatadas em pequena quantidade no tecido conjuntivo da lâmina própria dessa glândula. Por fim, a glândula coaguladora apresentou pequena quantidade de glicoproteínas neutras na borda em escova de seu epitélio e substância de composição desconhecida, sendo ausente o glicogênio. Conclui-se que as glândulas anexas do trato reprodutor da paca apresentam características histoquímicas que compartilham certa similaridade com outras espécies da ordem Rodentia, com a presença de glicoproteínas neutras e ácidas em algumas glândulas, principalmente no epitélio da glândula bulbouretal e na borda em escova do epitélio das demais glândulas.

Análise histoquímica das glândulas anexas do aparelho reprodutor do macho de paca (Cuniculus paca) / Histochemical analysis of the accessory glands of male paca (Cuniculus paca)

A paca (Cuniculus paca) é um roedor típico de regiões tropicais. Com a finalidade de estudar esta espécie selvagem para manejo adequado e sua preservação, objetivou-se neste trabalho caracterizar a histoquímica das glândulas anexas do trato reprodutor do macho da paca. Para este fim, cortes histológicos dessas glândulas foram submetidas às reações histoquímicas com Ácido Periódico de Schiff (PAS), Alcian blue (AB), PAS. + AB. e PAS + Amilase. Na glândula bulbouretral foi constatado que o epitélio produz secreção rica em glicoproteínas neutras e ácidas, glicosaminoglicanas, e em algumas regiões produz mais de um tipo de secreção. Não foi observada a presença de glicogênio no epitélio. Na glândula vesicular, seu epitélio em borda em escova corou-se por glicoproteínas neutras e também por substância de composição desconhecida, não contendo glicoproteínas ácidas, glicogênio ou glicosaminoglicanas. Verificou-se presença de pequena quantidade de glicoproteínas ácidas e neutras na próstata, em especial na mucosa, além de glicoproteínas ácidas carboxiladas e sulfatadas em pequena quantidade no tecido conjuntivo da lâmina própria dessa glândula. Por fim, a glândula coaguladora apresentou pequena quantidade de glicoproteínas neutras na borda em escova de seu epitélio e substância de composição desconhecida, sendo ausente o glicogênio. Conclui-se que as glândulas anexas do trato reprodutor da paca apresentam características histoquímicas que compartilham certa similaridade com outras espécies da ordem Rodentia, com a presença de glicoproteínas neutras e ácidas em algumas glândulas, principalmente no epitélio da glândula bulbouretal e na borda em escova do epitélio das demais glândulas.(AU)

Paca is a wild rodent typical of the tropical region. In order to study this species with focus on the proper management and preservation, this study aims to characterize the histochemistry of the accessory glands of the reproductive tract of the male paca. For this purpose, histological sections were stained with Periodic Acid-Schiff (PAS), Alcian Blue (AB), PAS + AB e PAS + Amilase. In the histochemical reaction of the bulbouretral gland was found that the epithelium produces secretion rich in neutral and acid glycoproteins, glycosaminoglycans, and in some regions produces more than one type of secretion. The epithelium did not contain any glycogen. In the vesicular gland the epithelium had bush border stained by neutral glycoproteins, but no acid glycoproteins, glycogen or glycosaminoglycan. The coagulating gland showed small amount of neutral glycoproteins in the brush border of the epithelium, without glycogen. It is concludes that the accessory glands of paca have histochemical characteristics that share some similarity with other species of the Order Rodentia, with some glands with neutral and acid glycoproteins, mainly in the epithelium of the bulbouretral gland and in the brush border of the other glands.(AU)

Morfologia e histoquímica das glândulas sexuais acessórias de Metachirus nudicaudatus, Didelphidae-Marsupialia / Morphology and histochemistry of accessory sex glands of Metachirus nudicaudatus, Didelphidae-Marsupialia

São descritas a morfologia e a distribuição de glicogênio e mucossubstâncias na próstata e nas glândulas bulbouretrais de Metachirus nudicaudatus (Geoffroy, 1803), única espécie do gênero. A próstata é envolvida pelas túnicas adventícia e muscular, e o estroma é formado pelo conjuntivo da mucosa uretral. O parênquima é constituído pelos túbulos secretores, disseminados na mucosa uretral, e que diferem histológica e histoquimicamente nos segmentos cranial, médio e caudal. Essas diferenças morfo-histoquímicas também são observadas nas partes externa, média e interna de cada túbulo. De um modo geral, os três segmentos prostáticos secretam mucossubstâncias neutras, porém o segmento caudal produz também glicogênio. Os três pares de glândulas bulbouretrais (laterais, intermédias e mediais) do Metachirus são envolvidas por uma cápsula conjuntiva e músculo estriado esquelético. O maior par é a bulbouretral lateral que é constituída por longos túbulos secretores de mucossubstâncias neutras. As bulbouretrais intermédias são formadas por túbulos ramificados, que produzem mucossubstâncias neutras, ácidas carboxiladas e ácidas sulfatadas. Os túbulo-ácinos ramificados das bulbouretrais mediais secretam mucossubstâncias neutras. O Metachirus não possui glândulas ampulares, vesículas seminais nem glândulas de coagulação.(AU)

This paper describes the morphology and distribution of glycogen and mucous substances in the prostate and the bulbourethral glands of Metachirus nudicaudatus (Geoffroy, 1803), the only species of the genus. The prostate is surrounded by the tunica adventitia, and muscle and stroma is formed by connective urethral mucosa. The glandular parenchyma consists of secretory tubules, scattered throughout the connective tissue of the urethral mucosa which differs histologically and histochemically in cranial, middle, and caudal segments of the prostate. These morpho-histochemical differences are also observed in the outer, middle and inner parts of the tubular epithelium of each prostatic segment. In general, prostatic segments secrete neutral mucous substances, and the caudal segment also produces glycogen. The three pairs of bulbourethral glands (lateral, intermediate and medial) are surrounded by a capsule of dense connective tissue and skeletal striated muscle. The glandular parenchyma is formed by tubules or branched tubuloacinar, covered by simple epithelium which is characteristic for each pair of glands. The lateral bulbourethral glands and the medial bulbourethral glands produce neutral mucous substances and the secretion of the intermediate bulbourethral glands consists of neutral mucous substances, carboxylated acids, and sulfated acids. The M. nudicaudatus does not have ampullary glands, seminal vesicles or coagulating glands.(AU)

Effect of sesame-supplemented diet on prostate and seminal vesicle histology of adult rat / Efecto de la dieta suplementada con sésamo en la histología de la próstata y vesícula seminal de ratas adultas

Infertility is a great concern among the people of reproductive age. The use of natural products obtained from traditional herbs is appealing. Studies show that antioxidants are important in improving male infertility. Thirty adult male rats were randomly divided into two regimen and control groups. The regimen group received diet containing 30 % sesame seed, while the control group received standard diet for 12 weeks. Histology of prostate and seminal vesicle were evaluated and serum levels of FSH, LH and testosterone concentrations were assessed as well. The results showed that, the diameter of peripheral epithelium and the volume density of the prostate epithelium increased but the volume density of the prostate stroma was decreased significantly in the regimen group compared to the control group. Central epithelium diameter and the volume density of the prostate lumen did not change significantly between two groups. In seminal vesicle, volume density of fibromascular and lumen decreased significantly in regimen group compared to control group. FSH and Testosterone level did not change while LH concentration increased significantly in the regimen group compared to the control group (P <0.03). This study shows that the sesame seed might improve male rat reproductive systems by histopathological changes in prostate and seminal vesicle.

La infertilidad es una gran preocupación para las personas en edad reproductiva y el uso de productos naturales obtenidos a partir de hierbas tradicionales es interesante. Los estudios demuestran que los antioxidantes son importantes en la mejora de la infertilidad masculina. Treinta ratas macho, adultas, se dividieron aleatoriamente en dos grupos, experimental y control. El grupo experimental recibió dieta con un 30 % de semillas de sésamo, mientras que el grupo control recibió dieta estándar durante 12 semanas. Fueron evaluadas la histología de próstata y vesícula seminal, así como los niveles séricos de las concentraciones de FSH, LH y testosterona. Los resultados mostraron que el diámetro del epitelio periférico y la densidad de volumen del epitelio de la próstata aumentaron, pero la densidad de volumen del estroma de próstata se redujo significativamente en el grupo experimental en comparación con el grupo control. El diámetro del epitelio central y la densidad de volumen del lumen de la próstata no presentaron cambios significativos entre los dos grupos. En la vesícula seminal, la densidad de volumen fibromuscular y el lumen se redujeron significativamente en el grupo de régimen en comparación con el grupo control. FSH y el nivel de testosterona no cambiaron, mientras que la concentración de LH aumentó significativamente en el grupo de régimen en comparación con el grupo control (P <0,03). Este estudio indica que la semilla de sésamo podría mejorar los sistemas reproductivos de ratas macho a partir de cambios histopatológicos en la próstata y las vesículas seminales.

Obesity inversely correlates with prostate-specific antigen levels in a population with normal screening results of prostate cancer in northwestern China

Serum prostate-specific antigen (PSA) is a diagnostic biomarker of prostate cancer and is possibly associated with obesity. This study aimed to explore the relationships between obesity indicators [body mass index (BMI) and waist circumference (WC)] with PSA in Chinese men. A cross-sectional study of men aged 30-85 years undergoing prostate cancer screening was conducted from August 2008 to July 2013 in Xi'an, China. Data were obtained from clinical reports, condition was recorded based on self-report including demographics, weight, height, and WC (>90 cm=obese). Fasting blood glucose (FBG) and prostate volume (PV) were assessed clinically. Patients were grouped by BMI (normal=22.9, overweight=23-27.4, obese≥27.5 kg/m2). PSA parameters of density (PSAD), PSA serum level, and PSA increasing rate per year (PSAR) were calculated per BMI and age groups (30-40, 41-59, 60-85 years). Obesity indicators (BMI and WC) and PSA parameter relationships were modeled by age-stratified linear regression. Of 35,632 Chinese men surveyed, 13,084 were analyzed, including 13.44% obese, 57.44% overweight, and 29.12% normal weight, according to BMI; 25.84% were centrally (abdominally) obese according to WC. BMI and WC were negatively associated with all PSA parameters, except PSAD and PSAR [P<0.05, BMI: β=-0.081 (95%CI=-0.055 to -0.036), WC: β=-0.101 (-0.021 to -0.015)], and independent of FBG and PV (P<0.05) in an age-adjusted model. In conclusion, obesity was associated with lower PSA in Chinese men. Therefore, an individual's BMI and WC should be considered when PSA is used to screen for prostate cancer.

Unraveling Brazilian Indian population prostate good health: clinical, anthropometric and genetic features

Purpose To compare dietary, lifestyle, clinical, anthropometric, genetic and prostatic features of Brazilian Indians and non-Indians (Amazon). Methods 315 men, 228 Indians and 89 non-Indians, ≥40 years old were submitted to digital rectal examination, serum prostate specific antigen (PSA), testosterone, TP53 and GSTP1 genotyping, anthropometric, lifestyle, dietary, personal and familial medical history. Prostatic symptoms were evaluated with the International Prostate Symptom Score (IPSS). Results Macuxis and Yanomamis represented 43.6% and 14.5% of Indians respectively who spontaneously referred no prostate symptoms. Mean IPSS was 7, range 3-19, with only 15% of moderate symptoms (score 8-19); Mean age was 54.7 years, waist circumference 86.6 cm, BMI 23.9 kg/m2. Yanomamis presented both lower BMI (21.4 versus 24.8 and 23.3, p=0,001) and prostate volume than Macuxis and “other ethnic groups” (15 versus 20, p=0.001). Testosterone (414 versus 502 and 512, p=0.207) and PSA (0.48 versus 0.6 and 0.41, p=0.349) were similar with progressive PSA increase with aging. Val/Val correlated with lower PSA (p=0.0361). Indians compared to control population presented: - TP53 super representation of Arg/Arg haplotype, 74.5% versus 42.5%, p<0.0001. -GSTP1 Ile/Ile 35.3% versus 60.9%; Ile/Val 45.9% versus 28.7%; Val/Val 18.8% versus 10.3%; p=0.0003. Conclusions Observed specific dietary, lifestyle, anthropometric and genetic profile for TP53 and GSTP1 may contribute to Brazilian Indian population prostate good health. .

Structural study of endopelvic fascia in prostates of different weights. Anatomic study applied to radical prostatectomy

PURPOSE: To evaluate the structure of the endopelvic fascia in prostates of different weights. METHODS: We studied 10 patients with BPH (prostates>90g); 10 patients with prostate adenocarcinoma (PAC) (prostates<60g) and five young male cadavers (control group). During the surgery a small sample of endopelvic fascia was obtained. We analyzed elastic fibers, collagen and smooth muscle. The stereological analysis was done with the Image Pro and Image J programs. Means were statistically compared using the one-way ANOVA with the Bonferroni test and a p<0.05 was considered statistically significant. RESULTS: The mean of the prostate weight was 122 g in BPH patients, 53.1g in PAC patients and 18.6g in control group. Quantitative analysis documented that there are no differences (p=0.19) in Vv of elastic fibers and in Vv of type III collagen (p=0.88) between the three groups. There was a significant difference (p=0<0.0001) in the quantification of SMC in patients with prostates >90g (mean=9.61%) when compared to patients with prostates <60g (mean=17.92%) and with the control group (mean=33.35%). CONCLUSION: There are differences in endopelvic fascia structure in prostates>90g, which can be an additional factor for pre-operatory evaluation of radical prostatectomy. .

Establishment of Reference Ranges for Prostate Volume and Annual Prostate Volume Change Rate in Korean Adult Men: Analyses of a Nationwide Screening Population

We aimed to determine normal reference ranges for prostate volume (PV) and annual PV change rate in a Korean nationwide screening population. Data from men who underwent a routine health check-up were collected from 13 university hospitals. The cohort comprised men aged > or =40 yr who had undergone 2 or more serial transrectal ultrasonographies. Men with initial PV>100 mL; serum PSA level>10 ng/mL; PV reduction>20% compared with initial PV, or who had history of prostate cancer or prostate surgery, were excluded. Linear regression and mixed effects regression analyses were used to predict mean PV and longitudinal change in PV over time. A total of 2,967 men formed the study cohort. Age, body mass index (BMI), and serum prostate-specific antigen (PSA) level were found to be significant predictors of PV. A predicted PV table, with a 95% confidence interval (CIs), was developed after adjusting for these 3 variables. Annual PV change rate was 0.51 mL/year (95% CI, 0.47-0.55). Annual PV change rate according to age was 0.68 mL/year, 0.84 mL/year, 1.09 mL/year, and 0.50 mL/year for subjects in their 40s, 50s, 60s, and > or =70 yr, respectively. Predicted annual PV change rate differed depending on age, BMI, serum PSA level and baseline PV. From a nationwide screening database, we established age-, PSA-, and BMI-specific reference ranges for PV and annual PV change rate in Korean men. Our newly established reference ranges for PV and annual PV change rate will be valuable in interpreting PV data in Korean men.

Structural modifications of the prostate in hypoxia, oxidative stress, and chronic ischemia

PURPOSE: Clinical studies have reported a correlation between pelvic ischemia and voiding dysfunction in elderly men. The aim of this study was to identify and compare prostate structural modifications in cultured cells and in a rabbit model after exposure to hypoxia, oxidative stress, and chronic ischemia. MATERIALS AND METHODS: Cultured human prostate smooth muscle cells (SMCs), epithelial cells (ECs), and stromal cells (SCs) were incubated under normoxia, hypoxia, and oxidative stress conditions by use of a computerized oxycycler system. We developed a rabbit model of chronic prostate ischemia by creating aorto-iliac arterial atherosclerosis. Markers of oxidative stress were examined by using fluorometric analysis and enzyme immunoassay. Prostate structure was examined by using Masson's trichrome staining and transmission electron microscopy (TEM). RESULTS: Lipid peroxidation was found in SMCs exposed to hypoxia and in all cell types exposed to oxidative stress. We identified protein oxidation in ECs exposed to hypoxia and in all cell types exposed to oxidative stress. Markers indicating oxidative damage were present in chronically ischemic rabbit prostate tissue. These reactions were associated with DNA damage. Prostate ischemia resulted in epithelial atrophy, loss of smooth muscle, and diffuse fibrosis. TEM showed swollen mitochondria with degraded cristae, loss of membrane, loss of Golgi bodies, degenerated nerves, and disrupted cell-to-cell junctions. CONCLUSIONS: Human prostate cells exhibited differential reactions to hypoxia and oxidative stress with widespread DNA damage. Structural modifications in ischemic prostate tissue were similar to those in cells exposed to oxidative stress. Structural changes due to ischemia and oxidative stress may contribute to prostatic noncompliance in aging men.

Um método de contagem de pontos adaptado como uma estratégia prática de quantificação do volume do tumor e percentagem do envolvimento da próstata por carcinoma, em produtos de prostatectomia / A method of counting points adapted as a practical strategy for the quantification of tumor volume and percentage involvement by prostate cancer, radical prostatectomy in product

Introdução. É consenso que o laudo anatomopatológico de produtos de prostatectomia radical deve relatar de forma quantitativa a extensão do carcinoma prostático, mas qual o método a ser usado não é consensual. Objetivos. Relatar a experiência de um método de contagem de pontos adaptado em produtos de prostatectomias (n= 143) adaptado de Billis et al., Int Braz J Urol. 2003.29:113-120. Material e métodos. As margens basal e apical foram processadas pelo método do cone. O restante da próstata foi dividido em 12 regiões em forma de quadrantes: cada uma representada com duas secções. Em cada fragmento, oito pontos equidistantes foram marcados diretamente sobre a lamínula com caneta permanente. Os pontos presentes dentro da área do tumor foram contados e expressos na forma de percentagem de envolvimento por carcinoma (PEC) ou como volume do tumor (VT). Estes foram comparados com o método quantitativo mais usual de número de secções envolvidas (NSE). Resultados. Os três métodos apresentaram correlação moderada significante com níveis pré-operatórios de PSA, mas esta foi maior para os métodos baseados na contagem de pontos: NSE (r = 0.32), PEC (r = 0.39) e VT (r = 0.44). Quando estratificados em três categorias, os três métodos mostraram associação com escore de Gleason ≥7, Gleason primário ≥4, invasão angiolinfática e perineural, extensão extraprostática, envolvimento de vesículas seminais e margens positivas. Conclusão. Os três métodos quantitativos estão associados a marcadores morfológicos de progressão do carcinoma da próstata. Os métodos baseados na contagem de pontos proposta apresentam mais forte correlação com níveis pré-operatórios de PSA sérico.

Objective: To evaluate a modified point-count method for quantifying carcinoma in prostatectomy specimens (n=143), adapted from Billis et al., Int Braz J Urol. 2003.29:113-120. Methods: The basal/apical margins were sampled using the cone method. The remainder of the gland was divided into 12 quadrant-shaped regions which had two slices sampled. Eight equidistant points were marked directly on the coverslip over each fragment. The points inside the tumoral areas were counted and expressed as the percentage of prostate gland involvement by carcinoma (PGI) and as the tumor volume (TV). Results: A significant correlation between the preoperative PSA level and each of the three quantitative estimations was found, but it was higher for both values (PGI and TV) obtained using the point-count method, viz.: number of slices involved (NSI) (r = 0.32), PGI (r = 0.39) and TV (r = 0.44). When the data sets were stratified into three categories, all three methods correlated with Gleason scores ≥7, primary Gleason scores ≥4, perineural / angiolymphatic invasion, extraprostatic extension, seminal vesicle invasion and positive margins. Conclusion: All three quantitative methods were associated with morphologic features of tumor progression. The results obtained using the modified point-count method correlated better with the preoperative PSA levels.

Pain during Transrectal Ultrasound-Guided Prostate Biopsy and the Role of Periprostatic Nerve Block: What Radiologists Should Know

Early prostate cancers are best detected with transrectal ultrasound (TRUS)-guided core biopsy of the prostate. Due to increased longevity and improved prostate cancer screening, more men are now subjected to TRUS-guided biopsy. To improve the detection rate of early prostate cancer, the current trend is to increase the number of cores obtained. The significant pain associated with the biopsy procedure is usually neglected in clinical practice. Although it is currently underutilized, the periprostatic nerve block is an effective technique to mitigate pain associated with prostate biopsy. This article reviews contemporary issues pertaining to pain during prostate biopsy and discusses the practical aspects of periprostatic nerve block.

Uroflowmetry in a Large Population of Brazilian Men Submitted to a health check up program and its correlation with ipss and prostate size

Purpose The aim of this study was to assess the uroflowmetry data in a large population of asymptomatic Brazilian men submitted to a health check up program and their correlation to IPSS and prostate size. Materials and Methods Asymptomatic men underwent a health check-up program between January and December 2012. The inclusion criteria were men between 40 and 70 years, IPSS ≤ 7, without bladder, prostate, urethral surgery, neurological diseases, urinary tract infection, PSA < 4.0 ng/dL and urinary volume higher than 150 mL. Urological assessment consisted of clinical history, IPSS, digital rectal examination (DRE), prostate specific antigen (PSA), urinalysis, ultrasonography and uroflowmetry. Results A total of 1041 asymptomatic men were included in this study. The average age was 49 years and average maximum flow rate was 17.4 mL/s. In spite of IPSS and prostate size increase with aging, they had a weak correlation with Qmax cutoffs (10 mL/s and 15 mL/s). A total of 85 men (8.3%) had more than 60 years, and even in this group, Qmax was higher than 15 mL/s. Out of 1041 men, 117 had IPSS less than 8 and Qmax less than 10 mL/s. Conclusions In asymptomatic men there is a weak correlation between IPSS, prostate size and uroflowmetric data. The establishment of different normal cutoffs seems to be complicated and uroflowmetry data should be interpreted with caution in order to avoid misdiagnosis. .

The prostate after administration of anabolic androgenic steroids: a morphometrical study in rats

Purpose Many adverse effects have been associated with abuse of anabolic-androgenic steroids (AAS), including disorders of the urogenital tract. The objective of this study is to analyze the morphological modifications in the prostate ventral lobe of pubertal and adult rats chronically treated with AAS, using morphometric methods. Materials and Methods: We studied 39 male Wistar rats weighing between 400 g and 550 g. The rats were divided into four groups: (a) control rats, with 105 days of age (C105) (n = 7); (b) control rats with 65 days of age (C65) (n = 9), injected only with the vehicle (peanut oil); (c) treated rats, with 105 days of age (T105) (n = 10) and (d) treated rats with 65 days of age (T65) (n = 13). The treated rats were injected with nandrolone decanoate at a dose of 10 mg.Kg-1 body weight. The steroid hormone and the vehicle were administered by intramuscular injection once a week for eight weeks. The rats were killed at 161 days of age (C105 and T105) and 121 days of age (C65 and T65) and the ventral prostate lobe was dissected and processed for histology. The height of the acinar epithelium, the surface densities of the lumen, epithelium and stroma were observed with X400 magnification using an Olympus light microscope coupled to a Sony CCD video camera, and the images transferred to a Sony monitor KX14-CP1. The selected histological areas were then quantified using the M42 test-grid system on the digitized fields. The data were analyzed with the Graphpad software. To compare the quantitative data in both groups (controls and treated) and the outcomes, Student's t-test was used (p < 0.05 was considered significant). Results: The weight (p < 0.001) and volume (p = 0.004) of the prostate ventral lobe showed differences between C65 and T65 groups and between C105 and T105 groups. The epithelium height showed no difference between groups C65 and T65 (p = 0.8509), but the T105 group showed an increase of 32% compared ...

Effect of ageing on albino rat female prostate [paraurethral glands]: a histological, immunohistochemical and morphometric study

Introduction: The prostate is not a gland exclusive to males, also being an organ of the female genital system

Aim of the work: The aim of this study was to detect histological, immunohistochemical and morphometric changes associated with ageing in female paraurethral glands [PUGs]

Materials and methods: Forty female rats were divided into two groups: adult group and aged group; each group comprised 20 rats. PUGs of both groups were removed, paraffin sections were obtained and stained with H and E, Mallory trichrome, periodic acid schiff, anti-alpha smooth muscle actin and anti-Ki67 immunostains, and then studied morphometrically

Results: The adult gland was formed of two lobes located on both sides of the urethra and showed large and small acini with wide lumens that contained periodic acid schiff-positive secretions. The acini were lined by cubical and/or columnar epithelium of two types: secretory and basal cells. Also, a few collagen fibres, thick periacinar smooth muscle layers and a few Ki67-positive cells were observed. Aged gland showed disarrangement of acinar epithelium, with formation of alveolus-like structures. Stroma was more vascular, with the appearance of newly developed acini and inflammatory infiltrate. Statistically, aged gland showed a highly significant increase in the number of acini, height of acinar epithelium, area% of collagen and Ki67 immunoexpression. In addition, a highly significant decrease in the area of acini, and a significant decrease in the acinar nuclear area and thickness of periacinar smooth muscle layers were detected

Conclusion and recommendation: Ageing of female prostate [PUG] was associated with abnormal histological and morphometric changes similar to those occurring in male prostate and this could adversely affect the health and quality of women's life. Therefore, further studies are needed to elucidate processes that maintain homeostasis of this gland

Gross anatomical, histological and histochemical studies on the postnatal development of the prostate gland of Gaddi goat / Estudios anatómicos macroscópicos, histológicos e histoquímicos sobre el desarrollo postnatal de la glándula prostática de la cabra Gaddi

The study was conducted on the prostate gland of Gaddi goat from one day old to more than five years of age divided into three groups viz; prepubertal (1 day old to < 18 months of age), pubertal (18 months to < 5 yrs of age) and postpubertal (> 5 yrs of age). The prostate comprised of corpus prostatae, a band like structure close to the junction of vesicular gland with the urethra, and the pars disseminate which extended in urethra well from its origin to the point of duct of bulbourethral gland. Microscopically, the corpus prostatae comprised of two compact glandular masses lying one over the other, dorsally over the origin of pelvic urethra covered by a thick fibro-reticular capsule. The gland composed of end pieces (luminated and non-luminated acini) and ducts arranged in lobulated fashion. The thickness of inter and intralobular connective tissue decreased with increased age at the expense of the growth of paraenchyma. With age the luminated secretory end pieces increased, while the non-luminatedend pieces decreased in the lobules of the gland. Glandular parenchyma were rich in mucous components by 6 month age serous and mucous components became almost equal and at 12 month age majority of the secretory end pieces turned in to serous type. The excretory ducts which were lined by stratified cuboidal epithelium in one day old kids changed to transitional epithelium in late prepubertal and pubertal animals. The glandular elements were PAS and Best's carmine reactive while interstitial connective tissue was non reactive. Mild alkaline phosphatase reaction was evident in the interstitial connective tissue cells. A strong acid phosphatase reaction was evident in the endothelium. BPB reaction for protein was moderate to intense. Ducts and acini were PAS and Alcian Blue reactive. The reaction for glycogen and AMPS contents in the gland increased with age. It was very intense in the pubertal animals. Moderate DNA activity, mild to moderate alkaline and acid...

Se realizó un estudio de la glándula próstatica de la cabra Gaddi, desde el día uno de nacimiento hasta después de los cinco años de edad, divididos grupos prepuberal (1 día a 18 meses de edad), puberal (18 meses a <5 años de edad) y post-púberes (más de 5 años de edad). La próstata estaba constituida por un cuerpo prostático, estructura como una banda cercana a la unión de la glándula vesicular con la uretra, y una pars diseminada la cual se extendía en las paredes de la uretra desde su origen hasta el punto de los conductos de la glándula bulbouretral. Microscópicamente, el cuerpo prostático está compuesto por dos masas compactas glandulares situadas una sobre la otra, dorsalmente sobre el origen de la uretra pélvica cubierta por una gruesa cápsula fibro-reticular. La glándula compuesta por piezas terminales (acinos luminal y no luminal) y conductos dispuestos en forma lobulada. El espesor del tejido conectivo inter e intralobulillar disminuyó con el aumento de la edad a expensas del crecimiento del parénquima. Con la edad aumentaron las piezas terminales secretoras luminales, mientras que en las piezas terminales no luminales, disminuyeron en los lóbulos de la glándula. El parénquima glandular era abundante en componentes mucosos a la edad de 6 meses, mientras que los componentes serosos y mucosas se equilibraron a los 12 meses de edad; la mayoría de las piezas finales secretoras se transformaron a tipo serosa. Los conductos excretores que estaban revestidos por epitelio cúbico estratificado en el día uno de las crías, cambió a epitelio de transición en los animales prepúberes y púberes. Los elementos glandulares fueron reactivos al PAS y al carmín de Best, mientras que el tejido conectivo intersticial no fue reactivo. Una reacción leve a la fosfatasa alcalina fue evidente en las células del tejido conectivo intersticial, mientras que una reacción fuerte se evidenció en el endotelio. La reacción de BPB para proteína fue de moderada a intensa. Los conductos...

Resultados comparativos en el tratamiento del cáncer de próstata localizado con intención curativa / Comparative results in the treatment with curative intent of localized prostate cancer

Introducción: El cáncer de próstata es la segunda causa de muerte por cáncer en los hombres. La determinación del Antígeno Prostático Específico (PSA) que permite detectar muchos tumores órgano-confinados, que hasta hace pocos años pasaban desapercibidos, ha llevado a la migración del diagnóstico hacia estadios más precoces de la enfermedad. La prostatectomía radical ha sido considerada tradicionalmente el tratamiento preferente para el cáncer de próstata localizado en los hombres con una esperanza de vida de 10 años o más. La radioterapia externa (RT) también se ha utilizado extensamente, principalmente en aquellos pacientes no pasibles a ser sometidos a procedimientos invasivos mayores por su elevado riesgo quirúrgico. Tanto la cirugía como la radioterapia externa han obtenido buenos resultados en el control del cáncer de próstata a largo plazo de acuerdo a series publicadas. Sin embargo parecería ser que la prostatectomia radical arrojado mejores resultados en función al periodo libre de enfermedad hasta evidenciarse progresión de la enfermedad. Objetivos: Comparar resultados obtenidos de la evolución de los pacientes con diagnostico de cáncer de próstata en estadio clínico localizado, que fueron tratados por una u otra modalidad. La comparación se realizo en función al periodo libre de enfermedad hasta presentar recidiva de enfermedad, ante pacientes del mismo grupo de riesgo. Materiales y métodos: Se realizó un estudio retrospectivo, analítico y documental de las historias clínicas de 139 pacientes con diagnostico de cáncer de próstata órgano confinado en el período comprendido entre marzo del 2001 y junio del 2010. Los pacientes fueron tratados quirúrgicamente o recibieron radioterapia conformada externa con una radiación promedio de7030 Gy (6500-7560 Gy). Con una edad promedio de 67 años y un seguimiento entre 12 meses y 9 años. Se valoro el periodo transcurrido libre de progresión de enfermedad hasta presentar recaída bioquímica...

Prostate cancer is the second leading cause of cancer death in men. Prostate specific antigen (PSA) determination can be used to detect organ confined tumors in earlier stages of disease. Radical prostatectomy has traditionallybeen considered as the preferred treatment for localized prostate cancer in men with life expectancy over 10 years. External radiation therapy (RT) has also been used extensively,mainly in patients with high surgical risk. Both surgery and radiotherapy have been successful in controlling prostate cancer, according to published series, but radical prostatectomy yielded better results according to disease free period. Objectives: To compare obtained results from the evolution of patients diagnosed with localizes prostate cancer, treated byeither modality. The comparison was carried out according to disease free interval until disease recurrence.Material and methods: A retrospective and documentary analysis was realized between March 2001 and June 2010,including 139 patients diagnosed with localized prostate cancer. The patients were treated surgically or with external radiotherapy, receiving a mean of 7030 Gy radiation (6500-7560 Gy). Patientshave a mean age of 67 years and have been monitored between 12 months and 9 years. Time elapsed free of disease progression without biochemical relapse were analyzed. Each treatment modality was compared with patients who have the same risk.Results: In low risk patients (55), 18 underwent surgical treatment, of which 16,6% observed biochemical recurrence...