The Endocrine Control of the Prostate

Abstract

The Endocrine Control of the Prostate By S. ZUCKERMAN BEIT MEMORIAL RESEARCH FELLOW (Fromi the Department of Humnan Anatomy, Oxfordl) FROM the turn of the present century until some five or six years ago, the prostate was an organ whose physiology was little discussed and even less investigated, and whose departures from the normal were events to be treated only by direct surgical methods. Within the past few years, facts about the endocrinology of this organ have multiplied so fast as to suggest a revision of present ideas on the treatment of one of the commoner of prostatic ailments-benign enlargement-and they have also achieved that measure of certainty which justifies their presentation to those whose interests in the organ are not purely scientific. Yet what is now recognized as an endocrinological approach to problems of the prostate is no new 'departure. Surgeons themselves had turned the physiological knowledge of the nineteenth century to account in the treatment of enlarged prostate by what today could well be described as one of the more drastic of endocrinological treatments-castration. This earlier phase in the endocrinological treatment of prostatic disorders, which came to a summary end about 1900, is no less interesting and instructive than that which has developed in recent years. CASTRATION AS TREATMENT FOR PROSTATIC OBSTRUCTION Enlargement of the prostate had been recognized as a clinical entity long before the dependence of prostatic growth on testicular function appears to have been appreciated. Samuel Collins, for example, described the ailment, somewhat vaguely it is true, as far back as 1685, attributing it to "indulgence in venery," and speaking of the presence of many "Hydatides-vesicles full of Liquor" in the "inward Penetrals " of the organ. Morgagni, during the earlier half of the eighteenth century, was also certainly aware of the disorder, and his extensive work on "The Seats and Causes of Diseases" (1769) contains numerous references to it, to observers other than himself who had described it, and to the part played by prostatic enlargement in obstructing the flow of urine. In 1786 John Hunter published his "Observations on the glands situated between the rectum and bladder, called vesicul] seminales," in which he wrote that" the prostate and Cowper's glands, and those of the urethra, which in the perfect male are soft and bulky, with a secretion salt to the taste, in the castrated animal are small, flabby, tough and ligamentous, and have little secretion." Whether or not he was the first to make this observation I do not know. The practice of castration, both as it applies to man himself and to his domestic animals, goes back to time immemorial, and it seems possible that the fact which OCT.-UROL. 1

PPARγ: A molecular link between systemic metabolic disease and benign prostate hyperplasia

“…The Skoptzys, a Russian sect in which the males underwent ritual castration at 35 years did not suffer from prostatic enlargement (Zuckerman, 1936). Furthermore, it has been shown that the absence of testicular function from a young age, either from castration or hypopituitarism, prevents the occurrence of BPH in men living into the over 55 age group.…”

Prostate development: a historical perspective

“…Aside from the work of Vesalius, an early description of the mammalian accessory sex glands was reported by Gerard Blasius in his treatise on comparative anatomy, which was published in 1674 and described simply as “glandulae” surrounding the neck of the bladder (Cole, 1949). At about the same period the importance of the clinical perspective was being developed through the observation by Samuel Collins that prostate enlargement caused bladder neck obstruction (Zuckerman, 1936). This was further established in the 18th century by Giambattista Morgagni, the founder of modern pathology (Franks, 1954).…”

“…In 1786 he wrote that ''The prostate and Cowper's glands, and those of the urethra, which in the perfect male are soft and bulky, with a secretion salt to the taste, in the castrated animal are small, flabby, tough and ligamentous, and have little secretion.' ' Zuckerman (1936) points out the notable fact that even though the inference of the observation would suggest that castration might be considered a treatment for the relief of prostate enlargement, the therapeutic value was not considered until almost a century later. The current understanding of prostate development and anatomy progressed through the publication of new findings each decade over the past century (Pallin, 1901;Lowsley, 1912;Johnson, 1920;Price, 1936;LeDuc, 1939;Huggins and Webster, 1948;Gil Vernet, 1953;McNeal, 1968McNeal, , 1978McNeal, , 1983Timms et al, 1994).…”

Quantitation of apoptotic activity following castration in human prostatic tissue in vivo

“…Control hosts were sacrificed on the day of castration. Experimental hosts were sacrificed at 13 different time points (post-castration day 1,2,3,4,5,7,8,9,10,14,17,18,21). Immediately following sacrifice, prostatic samples (grafts) were harvested.…”