You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Prostate & Genitalia1 Apr 20131175 “CHRONIC PROSTATIC ISCHEMIA”: MYTH OR REALITY? Mikhail Kogan, Igor Belousov, and Alexander Shangichev Mikhail KoganMikhail Kogan Rostov on Don, Russian Federation More articles by this author , Igor BelousovIgor Belousov Rostov on Don, Russian Federation More articles by this author , and Alexander ShangichevAlexander Shangichev Rostov on Don, Russian Federation More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.812AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In this study we correlated the morphology of the prostate tissue to the serum lipid levels and parameters of prostate arterial supply in refractory CPPS IIIB patients. METHODS Study group consisted of 10 patients with age of 27[24;29] years and with mean duration of CPPS IIIB of 4[3;6] years. Symptoms were identified by NIH-CPSI. Serum lipoprotein levels were documented. Intraprostatic blood flow velocity (Vmax, ml/sec), vascular resistance index (Ri) were assessed by prostatic Transrectal Color Doppler Sonography (TCDS) and were compared with data, obtained from 30 age matched volunteers. All patients underwent bifocal transrectal biopsy (bilateral peripheral zones). Histological evaluation was performed using Light, Electron Microscopy and Immunohistochemical Assessment [CD-31, CD-34, S-100, NSE markers]. The data presented as Me[LQ; UQ]. RESULTS Total score of symptoms was 28[21; 33], Pain Index 13[12; 16]. Serum level of lipoprotein: Triglycerides and Very Low Density Lipoprotein - over upper limit of normal in 80%, High Density Lipoprotein (HDL-C) - upper limit of normal in 20%, Total Cholesterol (TC), Low Density Lipoprotein and Index “(TC - HDL-C)/HDL-C” over upper limit of normal in 100%. The data of TCDS (p<0.005): Cases - Vmax: 3,8[3,2;5,2], Ri 0,92[0,81;0,92], Controls - Vmax: 19,9[18,6;22,7], Ri 0,62[0,62;0,64]. Histological Examination of the biopsy tissue: In all cases, no sign of inflammation was seen. We observed profound fibrosis with muscle tissue replaced by collagen fibers, and a significant number of mast cells around the perivascular region and the zone of fibrosis. Deposition of lipofuscin in the myocytes was found, while vascular density was reduced. In addition, when compared to controls, the arterial walls were thickened, hyalinized, the lumen of arterioles was significantly narrowed and tiny arterioles contained erythrocyte sludge. The venules showed more damaged , particularly with wall thinning. The endothelium of the capillaries was damaged by the fibrous tissue compression. Karyopyknocytosis was present in endotheliocytes as well as deposition of lipofuscin in the capillary walls. Nerve fibers were tiny, scanty and degenerated. The synapses demonstrated degenerative changes. CONCLUSIONS In our review, dyslipidimia as well as decreased arterial blood supply of the prostate correlated with the symptoms of the condition. Histological findings of the affected units were consistent with ischemic changes likely due to vascular disease. Although our study group is rather small, chronic ischemia of the prostate is likely an important factor in the development of the CPPS III B. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e480 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mikhail Kogan Rostov on Don, Russian Federation More articles by this author Igor Belousov Rostov on Don, Russian Federation More articles by this author Alexander Shangichev Rostov on Don, Russian Federation More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...