Morphologic features of benign prostatic hyperplasia depending on the size of intravesical prostatic protrusion

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.