Histological evaluation of benign prostatic hyperplasia treated by long‐term administration of chlormadinone acetate (CMA)

Abstract

Although the clinical effects of attempted nonsurgical treatment of benign prostatic hyperplasia have been well documented, detailed histological evaluation of the effects of treatment appears to be limited. The effect of long-term administration of an antiandrogen, chlormadinone acetate (CMA), on benign prostatic hyperplasia was evaluated with histological comparison of two biopsy specimens, one before treatment and one after treatment. Secretory epithelium showed obvious regressive changes with occasional basal cell prominence after CMA treatment. Stromal elements, however, did not show any marked changes, except for occasional edematous loosening. Scores of multiple epithelial parameters tended to be correlated with clinical improvement in urinary obstructive symptoms, especially in patients with predominant glandular hyperplasia. These results suggest that long-term administration of the potent antiandrogen CMA to inhibit dihydrotestosterone-receptor binding might be a useful therapeutic maneuver in patients with glandular hyperplasia, without any deterioration of the stromal component.

Immunohistochemistry of the Canine Prostate.

“…Chlormadinone acetate (CMA) is a steroidal antiandrogen that is widely used in the medical management of human BPH or prostatic carcinoma [9,12]. Histologically, CMA produced marked atrophy of the glandular epithelium (Tables 1, 2).…”

Chlormadinone Acetate (CMA) Induces Apoptosis on Canine Spontaneous Benign Prostatic Hyperplasia (BPH).

“…The atrophic effect of CMA on the human prostatic hyperplasia has been reported by several authors [8,11]. The antiandrogenic mechanisms of CMA has been evaluated biochemically and immunohistochemically, such as androgen receptor content, and steroid 5a-reductase type II activity in the prostate [11,[19][20][21][22].…”

“…Canine BPH is believed by many investigators to be an appropriate model for the study of human BPH, although there are important differences between the conditions in the two species [1,10,18,30,34]. Thus, the human disease is often a multinodular process thought to arise from a priurethal stromal nodule, which is then secondarily invaded by glandular elements [8]. In contrast, canine BPH is a diffuse epithelial or glandular process with less stromal involvement [4].…”

“…Chlormadinone acetate (CMA) is a steroidal antiandrogen that is widely used in the medical management of human BPH or prostatic carcinoma [8,11]. The atrophic effect of CMA on the human prostatic hyperplasia has been reported by several authors [8,11].…”

Immunohistochemical Studies of the Effect of Chlormadinone Acetate (CMA) on Prostatic Hyperplasia.

“…Canine BPH is believed by many investigators to be an appropriate model for the study of human BPH, although there are important differences between the conditions in the two species [9,30]. Thus, the human disease is often a multinodular process thought to arise from a periurethal stromal nodule, which is then secondarily invaded by the glandular elements [7]. In contrast, canine BPH is a diffuse epithelial or glandular process with less stromal involvement [4].…”