Blood supply to the pelvic organs of outbred male rats was diminished by graduated constriction of the distal part of the inferior vena cava. Deficiency of intramural blood supply in prostate and urinary bladder was revealed by bioimpedance harmonic analysis according to the magnitude of first cardiac peak in the bioimpedance spectrogram. In 1-1.5 months, the histological examination revealed the glandular-stromal form of progressive benign prostatic hyperplasia in all ischemic rats. The development of hyperplasia was not accompanied by the changes in testosterone, dihydrotestosterone, or estradiol in blood and prostatic tissue. Assessment of vesical functional status by recording the intravesical pressure during infusion cystometry revealed an increase in the amplitude of spontaneous fluctuations of detrusor tone and intravesical pressure during bladder filling, which can be considered as indicator of detrusor hyperactivity. The data conclude that chronic ischemia of pelvic organs is an individual pathogenic factor in the development of benign prostatic hyperplasia and associated urinary disorders.
Background. The etiology of benign prostatic hyperplasia (BPH) has not been fully studied. The main role in the induction of prostate tissue proliferation is assigned to the metabolism of testosterone. Recently, it has been reported that one of the risk factors for BPH is a chronic violation of the blood supply to the prostate.The study objective is to determine the level of reproductive hormones in blood serum and prostate tissue when creating a model of chronic ischemia.Materials and methods. The model of chronic pelvic ischemia was created in 10 white non-linear mature rats by partial ligation of the inferior vena cava. The control group of the study consisted of 10 male rats of the same age. After 1.5 months, we performed a hormonal study in all rats (n = 20) determining the concentration of testosterone, dihydrotestosterone and estradiol in the blood and prostate tissue. Also, in all animals (n = 20), a morphological study of the prostate was performed.Results. We’ve found a significant increase in prostate mass in the main group of rats by 16.4 % (p <0.05). Animals with BPH and impaired blood supply to the prostate had changes in their hormonal status: increased levels of testosterone (p <0.05) and dihydrotestosterone (p >0.05) in the prostate tissue.Conclusion. Long-term ischemic disorders in the prostate may be a trigger factor for the development of BPH due to an increase in the concentration of testosterone.
Benign prostatic hyperplasia – one of the most common diseases in older men. The treatment strategy for benign prostatic hyperplasia consists in its drug therapy, or active surgical tactics. The indication for planned surgical treatment of benign prostatic hyperplasia is the progression of symptoms of the lower urinary tract, which are not amenable to drug correction. Men with a large prostate volume of more than 80 m3, with severe symptoms of the lower urinary tract, with a history of acute urinary retention episodes, represent a difficult group of patients in terms of choosing the tactics of surgical treatment. This article discusses the most common operations that are used in the treatment of benign prostatic hyperplasia (especially of large sizes): open adenectomy, transurethral resection of the prostate gland, enucleation of benign prostatic hyperplasia using a holmium laser, embolization of an artery of the prostate gland. Surgical treatment of benign prostatic hyperplasia requires an individual approach to the patient, taking into account his age, concomitant pathology and clinical symptoms.
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