How Important Are Prostaglandins in the Urology of Man?

Abstract

Although the discovery of prostaglandins (PGs) is to be attributed to investigations into the semen plasma and the accessory sex glands, it has been the female genital function and its relationship to the PGs rather than male genital function which has been the subject of intensive research in the past. This survey is intended to provide some idea of which known PGs play a part in the function of the male genital tract and of the urinary bladder. PGs, above all PGE, occur in testicle tissue, have a modulating effect on the LH-dependent steroid synthesis and possibly influence sperm density and sperm function. The PGs certainly play a part in the motility of the vas deferens and participate decisively in blood flow regulation in male genitals. The basal tone and contractility of the testicle capsule are partly controlled by PGs. Connections between reduced PGE levels in semen plasma and infertility are discussed. PGs are partly responsible for the basal tone and the emptying mechanism in the urinary bladder, and are transmitters acting between the nervous system and the muscular stimulus response. The significance to be attributed to PGs and the effect of urinary bladder carcinomas on their synthesis is still largely unclear. Animal studies and in vitro investigations reveal interesting aspects. The seminal vesicle synthesizes very large amounts of PGs, which probably display their action in the semen plasma and with this also in the female genital tract; there is a close relationship between the steroid and prolactin effects and PGs in the prostate gland. Together with prolactin, PGs are modulators of the stimulatory effects of steroids on this organ. On the other hand, the PGs formed in the prostate gland also exert a certain "remote action' in semen an in the urinary bladder. The importance of PGs in inflammatory changes in the prostate gland and the therapeutic possibilities for these clinical symptoms which may result from influencing PGs can be seen from some studies, but it is not yet possible to draw a final conclusion a this point in time.