A Study on the Relationship between Histologic Composition and Clinical Symptoms in Benign Prostatic Hyperplasia

Rim, Hee Kwan; Rim, Joung Sik; Moon, Hyung Bae

Abstract

To determine whether the relative proportion of stromal and epithelial hyperplasia is related to the development of symptomatic benign prostatic hyperplasia, we measured the percentage of stroma and gland by quantitative morphometric analysis in the prostate adenomas from men with symptomatic and asymptomatic BPH. Prostate adenomas were obtained from 9 men with asymptomatic BPH undergoing cysto-prostatectomy for invasive transitional cell carcinoma of the bladder (group 1), 15 with symptomatic BPH undergoing transurethral resection of the prostate and 5 with symptomatic BPH undergoing open prostatectomy( <60g : group 2a), and 15 with symptomatic BPH undergoing open prostatectomy( >= 60g: group 2b). The results obtained were as follows. 1. The prostate adenomas from group 1, 2a and 2b contained 57.1 %, 68.2% and 68.8% of stroma and 19.69t, 14.3% and 13.2% of epithelium and 23.3%, 17.5% and 18.0% of glandular lumen, respectively. The difference in percentage of stroma, epithelium and glandular lumen in the prostate adenoma from men with symptomatic and asymptomatic BPH were statistically significant(P <0.05). 2. The prostate adenomas from 24 men with modified Boyarsky obstructive symptom scoring over 10 were compared with 11 men with scores less than 10. The results were 68.2% vs. 69.3%, 13.8% vs. 13.5% and 18.0% vs. 17.2% of stroma, epithelium and glandular lumen, respectively ( P>0.1). 3. The prostate adenomas from 19 men with modified Boyarsky irritative symptom scoring over 7 were compared with 16 men with scores less than 7. The results were 67.6% vs. 69.9%, l3.8% vs. 14.1% and l8.0% vs. 16.2% of stroma, epithelium and glandular lumen, respectively ( P>0.1) . In conclusion, the prostate adenomas from men with symptomatic BPH were composed of more proportion of stroma and lesser proportion of epithelium and glandular lumen than those from men with symptomatic BPH. The histological composition of prostate adenomas were not related to the severity of obstructive or irritative symptom.