Морфологическая характеристика ткани гиперплазированной предстательной железы при хроническом простатите

Abstract

Introduction. Benign prostatic hyperplasia (BPH) is a common disease wich is characterized by the proliferation of periurethral prostate glandular tissue. Infectious and inflammatory processes in the prostate play an important role in proliferation and hyperplasia, causing a significant deterioration in prostate metabolism and proliferation acceleration. This leads to progressive growth of the hyperplastic tissue in the prostate gland (PG). Тhe aim of study was to perform a comparative analysis of morphological changes in prostate hyperplastic tissue in patients with chronic prostatitis, who underwent various types of surgical treatment for BPH. Materials and methods. A comparative analysis of morphological changes in prostate tissue was performed, using a material from 276 patients with chronic prostatitis and BPH, who underwent various types of surgical treatment. The patients were divided into three groups: group I (n = 50) - patients who underwent surgical transvesical adenomectomy, group II (n = 76) - patients who underwent transurethral resection of the prostate (TURP) and group III (n = 150) - men who underwent holmium laser enucleation of the prostate. Fragments of the removed prostate tissue were fixed with neutral 10% formalin. The tissue samples were numerated automatically, using DIAPATH Donatello processor. Microscopic examination was carried out using a light microscope ZEISS «Axioskop 40» (eyepiece x 10, objectives x 5, x 10, x 20, x 40, 100). Results. Morphological features of resected prostate from patients with BPH and from patients with its combination with chronic bacterial inflammation were analyzed. The morphological picture varies from acute purulent inflammation to pronounced chronic lymphoplasmacytic inflammation around the acini. The features of morphological changes in the prostate after transvesical adenomectomy, TURP and laser enucleation were also studied. It was shown, that against the background of a chronic infectious and inflammatory process as well as a gross cicatricial process in the prostate, the organ anatomy, as well as the architectonics of vessels are disrupted, which can lead to a decrease in surgical treatment effectiveness. Discussion. In the majority of patients with BPH histological examination reveals a lymphoplasmacytic reaction of varying severity, which causes anatomical abnormalities and microcirculation deterioration. This condition significantly increases the risk of postoperative complications, requiring long-term conservative therapy and sometimes another surgical intervention. Conclusions. Against the background of a chronic infectious and inflammatory process, a gross cicatricial process in the prostate, its anatomy as well as vessel architectonics become disrupted, leading to a decrease in the effectiveness of surgical treatment. In the comparative study of morphological characteristics after various types of surgical procedures, it was revealed that the least significant changes were detected after laser enucleation of prostatic hyperplasia.