MP45-19 THE EFFECTS OF LOCAL ATHEROSCLEROSIS OF THE PROSTATIC ARTERY IN PATIENTS WITH PROSTATIC ENLARGEMENT

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Basic Research & Pathophysiology1 Apr 2018MP45-19 THE EFFECTS OF LOCAL ATHEROSCLEROSIS OF THE PROSTATIC ARTERY IN PATIENTS WITH PROSTATIC ENLARGEMENT Nobuhiro Haga, Hidenori Akaihata, Ken Aikawa, Kei Ishibashi, and Yoshiyuki Kojima Nobuhiro HagaNobuhiro Haga More articles by this author , Hidenori AkaihataHidenori Akaihata More articles by this author , Ken AikawaKen Aikawa More articles by this author , Kei IshibashiKei Ishibashi More articles by this author , and Yoshiyuki KojimaYoshiyuki Kojima More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1458AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Chronic ischemia in the pelvis induces benign prostatic enlargement (BPE) in animal studies. However, whether local atherosclerosis induces BPE in humans has not yet been elucidated. To elucidate the mechanism of occurrence of BPH/BPE induced by the local atherosclerosis in humans, the association between local atherosclerosis and clinical background was investigated, and the molecular biological analyses was performed by using human surgical specimens. METHODS A total of 69 consecutive patients who underwent robot-assisted radical prostatectomy (RARP) participated in this prospective study. To evaluate actual local atherosclerosis, prostatic arteries were removed during RARP. Microscopic assessment of local atherosclerosis was classified as one of three degrees of narrowing (minimal, moderate, and severe) according to the degree of obstruction of the inner cavity of the prostatic artery. The expression of the several biomarkers related to the chronic ischemia and cell proliferation of the prostate was investigated by immunohistochemistry. RESULTS Local atherosclerosis of the prostatic artery was analyzed in 576 specimens (8.3±5.0 specimens per patient). Local atherosclerosis was significantly more severe in patients who had a history of treatment for benign prostatic hyperplasia (P=0.02). Prostate size was significantly lager in the severe local atherosclerosis group than in the minimal and moderate local atherosclerosis groups (P<0.001 and P=0.03, respectively). There was a significantly negative correlation between prostate size and patency of the prostatic artery (r=-0.30, P=0.01). Multivariate analyses showed that prostate size was significantly correlated with local atherosclerosis (P=0.04). In the immunohistochemical analyses, the positive expression rate of malondialdehyde (MDA), Hypoxia-inducible Factor (HIF)-1α, transforming growth factor (TGF)-β1and basic fibroblast growth factor(bFGF) in the prostate were significantly higher in the patients with local atherosclerosis than in the patients without local atherosclerosis (all P<0.01, respectively). CONCLUSIONS In human surgical specimens, local atherosclerosis of the prostatic artery induced prostatic enlargement. The increase in the obstruction in the prostatic artery was proportional to the increase of prostate size. Chronic ischemia due to local atherosclerosis led to the upregulation of oxidative stress and HIF-1α levels. Increase of TGF- β1and bFGF induced by oxidative stress and HIF-1α in the prostate might induce the enlargement of the prostate by the stromal proliferation, transdifferentiation, and extracellular matrix production. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e605 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Nobuhiro Haga More articles by this author Hidenori Akaihata More articles by this author Ken Aikawa More articles by this author Kei Ishibashi More articles by this author Yoshiyuki Kojima More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...