Yokota Takeshi, Honda K, Tsuruya Y, Nomiya M, Yamaguchi Osamu, Gotanda K, Constantinou Christos E
Department of Urology, Fukushima Medical School, Fukushima, Japan.
Prostate. 2004 Feb 1;58(2):156-63. doi: 10.1002/pros.10318.
Benign prostatic hypertrophy (BPH) produces a variety of changes in the urodynamic pattern of micturition and is usually associated with high detrusor voiding pressure and poor urine flow-rate. In most previous experimental models, designed to simulate this condition, some degree of obstruction is immediately imposed by the technique employed to produce urethral occlusion. Consequently these models cannot reproduce the gradual onset of obstruction. In the present study a canine prostatic enlargement model, using 5alpha-dihydrotestosterone (DHT) + 17beta-estradiol (E) was adapted in order to produce a more gradual onset of partial obstruction and impaired voiding.
Hormonally induced prostatic enlargement was produced using seven beagles, given DHT 75 mg/day together with E 0.75 mg/day for 28 days via an implantable pump. The functional effects of DHT + E treatment on micturition pressure/flow were measured in the conscious animal. Identical measurements were also made using a separate older group of five beagles with symptoms of BPH. In addition seven beagles similarly instrumented were used as controls.
Pressure/flow studies show that DHT + E produced obstructive micturition, characterized by a significantly increased micturition detrusor pressure, from 33.3 +/- 10.5 to 50.8 +/- 10.7 cmH(2)O and significantly decreased low urine flow-rate from 8.6 +/- 2.1 to 6.9 +/- 0.9 ml/sec. Associated with the obstructive micturition, this treatment increased wet prostate weight from 11.9 +/- 2.5 to 31.6 +/- 10.0 g. Prostate volume of the BPH beagles was 29.3 +/- 8.9 g. Morphologic studies show that DHT + E produced epithelial hyperplasia extending focally into the lumen.
Hormonally induced prostate growth produced bladder obstruction, in terms of pressure/flow characteristics, that are analogous to BPH. It is suggested that this type of hormonal treatment can be used to create a model for the study of the effects of controlled increased in prostate growth and the development of BPH on micturition.
良性前列腺增生(BPH)会使排尿的尿动力学模式发生多种变化,通常与逼尿肌排尿压力升高和尿流率降低有关。在以前大多数旨在模拟这种情况的实验模型中,用于产生尿道阻塞的技术会立即造成一定程度的梗阻。因此,这些模型无法再现梗阻的逐渐发生过程。在本研究中,采用一种犬前列腺增生模型,使用5α-二氢睾酮(DHT)+17β-雌二醇(E),以产生更逐渐发生的部分梗阻和排尿障碍。
使用7只比格犬通过可植入泵给予DHT 75毫克/天和E 0.75毫克/天,持续28天,以产生激素诱导的前列腺增生。在清醒动物中测量DHT + E治疗对排尿压力/流量的功能影响。对另一组有BPH症状的5只年龄较大的比格犬进行同样的测量。此外,将7只同样植入仪器的比格犬用作对照。
压力/流量研究表明,DHT + E产生梗阻性排尿,其特征为排尿逼尿肌压力显著升高,从33.3±10.5厘米水柱升至50.8±10.7厘米水柱,低尿流率显著降低,从8.6±2.1毫升/秒降至6.9±0.9毫升/秒。与梗阻性排尿相关的是,这种治疗使前列腺湿重从11.9±2.5克增加到31.6±10.0克。BPH比格犬的前列腺体积为29.3±8.9克。形态学研究表明,DHT + E导致上皮增生,局部延伸至管腔。
激素诱导的前列腺生长在压力/流量特征方面产生了类似于BPH的膀胱梗阻。建议这种激素治疗类型可用于创建一个模型,以研究前列腺生长的可控增加以及BPH的发展对排尿的影响。