Chronic prostatitis in benign prostatic hyperplasia.

Abstract

Gross and histological studies of surgically resected prostate glands and glands recovered at autopsy have shown a close correlation between the type of hyperplasia in the gland and the degree of chronic prostatitis. Three types of hyperplasia are recognised. In Type I there is mainly an adenomatous hyperplasia; Type II shows a mixed hyperplasia with proliferation of glandular and fibro-muscular structures whilst in Type III hyperplasia of fibro-muscular structures predominates with minimal proliferation of acini and ducts. The heaviest inflammatory infiltration which may be granulomatous is usually found in Type II and the gland feels firm or hard and clinically may mimic carcinoma. It is postulated that in Type II hyperplasia, islands of acini and ducts are compressed by dense bands of fibro-muscular tissue with consequent obstruction of ducts and stagnation of prostatic fluid. Further compression leads to destruction of the walls of ducts and acini with escape of prostatic fluid into the stroma to produce an inflammatory reaction.