Urethrolysis and External Urethroplasty in the Female

Abstract

The constitution of glands surrounding the human female urethra has been under debate; especially regarding as to what extent they equal the male prostate. Defining their composition may help to understand the development of neoplasms arising from this tissue.The aim of this study was to define the existence, structure, and arrangement of a possible human female prostate.Urethras of 25 women were investigated by immunohistochemistry and stained with specific monoclonal antibodies against prostate‐specific antigen (PSA, mono‐ and polyclonal antibody), prostate specific alkaline phosphatase (PSAP), and androgen receptor (AR). From two urethras, which underwent a totally serial work up with PSA‐staining, a three‐dimensional model of the urethra and the prostatic glands was created to enable 3D‐perception of the results.The main outcome measures used in this study were identifying glandular structures in hematoxylin‐eosin‐staining, positive staining with the respective antibodies, and 3‐D orientation of described glands.Fourteen of 25 patients had glandular structures encircling the urethra. Twelve of 14 showed positive staining for PSA, PSAP, and AR in gland acini, while the excretory ducts, the urethra, and the surrounding stroma did not express those proteins. The strongest PSA and PSAP expression was found in apical cytoplasm of the glandular cells, and AR was confined to cell nuclei. Prostatic glands were located laterally to the distal half of the urethra.A female prostate was found in every second woman in this study and can be discriminated from other urethral caverns and immature paraurethral ducts. Possible neoplasms of this source tissue expressing the prostate‐specific markers may therefore be denominated as female prostate tumors. Dietrich W, Susani M, Stifter L, and Haitel A. The human female prostate—immunohistochemical study with prostate‐specific antigen, prostate‐specific alkaline phosphatase, and androgen receptor and 3‐D remodeling. J Sex Med 2011;8:2816–2821.