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Kim, Lee, Kim, Cho, Han, Kang, and Yoo: Relationships between Relative Proportion of Tissue Components, Urodynamic Parameters, and Low Urinary Tract Symptoms in Patients with Benign Prostatic Hyperplasia
Original Article
Lower Urinary Tract Dysfunction
Korean Journal of Urology

Korean Journal of Urology 2009; 50(9): 859-864.

Published online: 18 September 2009

DOI: https://doi.org/10.4111/kju.2009.50.9.859

Relationships between Relative Proportion of Tissue Components, Urodynamic Parameters, and Low Urinary Tract Symptoms in Patients with Benign Prostatic Hyperplasia

Hyun Seung Kim, Seung Wook Lee, Eun Kyung Kim1, Jeong Man Cho, Kyu Heung Han, Jeong Yoon Kang, Tag Keun Yoo

Department of Urology, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea.

1Department of Pathology, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea.

Correspondence to: Tag Keun Yoo. Department of Urology, Eulji Hospital, Eulji University School of Medicine, 14, Hangeulbiseok-gil, Nowon-gu, Seoul 139-711, Korea. TEL: 02-970-8305, FAX: 02-970-8349, ytk5202@eulji.ac.kr

Received 18 February 2009       Accepted 22 August 2009

Copyright © The Korean Urological Association, 2009

Abstract

Purpose

This study was designed to investigate the relationship between the histological composition of the prostate, preoperative clinical parameters, and the results of transurethral resection of prostate (TURP).

Materials and Methods

A total of 61 patients with benign prostatic hyperplasia (BPH) who had undergone TURP were enrolled retrospectively. Slides were surveyed for relative areas (%) of glandular epithelium (GE), stroma (ST), and smooth muscle (SM) in stroma by performing immunohistochemistry, and the mean outcomes were calculated with a computer-assisted image analyzer (×200).

Results

Total prostate volume was less than 40 ml in 19 patients (group 1), 40 to 80 ml in 23 patients (group 2), and more than 80 ml in 19 patients (group 3). The percentage of SM was significantly greater in group 1 (29.5±4.2%) than in group 3 (23.7±3.2%), but GE and ST did not differ significantly. AG number was significantly higher in group 3 than in the other groups but did not correlate with SM. Improvements in International Prostate Symptom Score, which were similar in each group, were positively correlated with SM.

Conclusions

SM in prostate adenoma is increased in men with a small prostate and may play an important role in lower urinary tract symptoms in small BPH

Keywords: Prostatic hyperplasia, Transurethral resection of prostate

Figures and Tables

Fig. 1
High power view shows (A) marked proliferation of smooth muscle bundles compared with the small proportion of glandular components, and (B) dominant complex glandular proliferation compared with the smooth muscle component (immunohistochemical stain, ×200).
kju-50-859-g001
Table 1
Baseline characteristics of the patients
kju-50-859-i001

Group 1: prostate size<40 ml, Group 2: 40 ml≤prostate size<80 ml, Group 3: prostate size≥80 ml, IQR: inter-quartile range, PSA: prostate-specific antigen, PVR: post-void residual urine, AG no.: Abrams-Griffiths number=PdetQmax-2Qmax, IPSS: International Prostate Symptom Score

Table 2
Proportion of tissue elements in each group
kju-50-859-i002

Group 1: prostate size<40 ml, Group 2: 40 ml≤prostate size<80 ml, Group 3: prostate size≥80 ml, IQR: inter-quartile range

Table 3
Comparison of postoperative results
kju-50-859-i003

Group 1: prostate size<40 ml, Group 2: 40 ml≤prostate size<80 ml, Group 3: prostate size≥80 ml, IQR: inter-quartile range, Qmax: maximum flow rate, PVR: post-void residual urine, IPSS: International Prostate Symptom Score

Table 4
Relationships between each element and clinical factors
kju-50-859-i004

GE: glandular epithelium, ST: stroma, SM: smooth muscle, Qmax: maximum flow rate, AG no.: Abrams-Griffiths number= PdetQmax-2Qmax, IPSS: International Prostate Symptom Score

Table 5
Partial correlation between Improvement of International Prostate Symptom Score (IPSS) and tissue elements adjusted by prostate volume
kju-50-859-i005

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