It is widely believed that benign prostatic hyperplasia (BPH) is associated with aging. Thus, the question arises whether or not a correlation exists between the well known prostatic androgen and estrogen accumulation and aging. To address this question, we measured 5 alpha-dihydrotestosterone (DHT), testosterone, estradiol, and estrone in epithelium and stroma of six normal (NPR) and 19 BPH and correlated the values with the age of the donors (26-87 yr). The mean DHT level in NPR epithelium was significantly higher than in NPR stroma, and also significantly higher than in epithelium and stroma of BPH. The epithelial DHT level of NPR and BPH decreased with age, the correlation being statistically significant. The stromal DHT level of NPR and BPH showed no correlation with age. Concerning testosterone, generally rather low values were found which showed no correlation with age. The mean levels of estradiol and estrone were significantly higher in BPH stroma as compared to BPH epithelium as well as to NPR epithelium and stroma. In NPR, the mean levels of estradiol and estrone were significantly higher in epithelium than stroma. In NPR and BPH, the stromal estradiol and estrone levels increased significantly with age. In epithelium such a correlation between the estrogen levels and age was not found. Our results indicate that the prostatic accumulation of DHT, estradiol, and estrone is in part intimately correlated with aging, leading with increasing age to a dramatic increase of the estrogen/androgen ratio particularly in stroma of BPH.

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Effect of aging on endogenous level of 5 alpha-dihydrotestosterone, testosterone, estradiol, and estrone in epithelium and stroma of normal and hyperplastic human prostate.

The etiology of human benign prostatic hyperplasia (BPH) is poorly understood. However, as reviewed in detail in various chapters of Hinman’s monograph on benign prostatic hypertrophy (Hinman 1983) there is strong physiological evidence that the development, integrity and secretory function of the human prostate are largely under the control of functioning testes. Moreover, early clinical experience (Huggins and Stevens 1940) and histological data (Wendel 1972) indicate that castration induces regressive alterations in the epithelial compartment of established BPH. It has also been shown that canine BPH can be induced by androgens (Walsh and Wilson 1976; DeKlerk et al. 1979; Moore et al. 1979a).

Androgens and human benign prostatic hyperplasia (BPH)

Androgen receptors were measured in transitional cell carcinoma tissues obtained from 13 patients with bladder tumours and 3 patients with ureteric tumours. Scatchard analysis of binding of mibolerone, a synthetic androgen, was used for receptor measurement. None of the patients were receptor positive. This study suggest that human male hormones do not play any direct role in the malignant transformation of human transitional cell epithelium.

Androgen receptors in transitional cell carcinoma.

Summary The problems and the interpretation of combined stereological-biochemical investigations in benign prostatic hyperplasia (BPH) research are discussed. As BPH is characterized by a primary stromal enlargement the role of the smooth muscle cell (SMC) is focussed. For determination of the single cell volume of the SMC several methods are applicable leading to different results. Thus interpretation of these results has to be done with caution. Finally as an example there is a discussion of a correlation of stereological-biochemical dates of human prostatic tissue samples.

Do's and Dont's in Stereological Pathology or Possibilities of Stereological-Biochemical Correlation in Uropathology

Symptomatologie und Lebensqualität nach Transurethraler Resektion der Prostata (TUR-P)

Although the influence of the testis on prostatic function had been suspected during the nineteenth century, the pioneering work of Huggins and Stevens established its role and gave rise to the concept of androgen dependence of prostatic tissue.26 Benign prostatic hyperplasia (BPH) does not occur in the absence of a normally functioning testis. Biochemically, BPH is associated with an abnormal accumulation of 5α-dihydrotestosterone in the prostatic tissue. The prostate does not develop in patients with male pseudohermaphrodism due to 5α-reductase deficiency or androgen insensitivity (Fig. 1).

Androgen Levels and Binding in Benign Prostatic Hyperplasia

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Androgen Levels and Binding in Benign Prostatic Hyperplasia