Cai Jian-liang, Xin Dian-qi, He Qun, Tang Xiu-qin, Na Yan-qun
Department of Urology, Peking University Shougang Hospital, Beijing 100041, China.
Zhonghua Yi Xue Za Zhi. 2008 May 13;88(18):1284-8.
To study the pathological change of benign hyperplastic prostate after removal of the innervation of cholinergic parasympathetic pelvic nerve.
Sixty-five male spontaneous hypertension rats (SHRs) were randomly assigned into 3 groups: operation group (n = 30) undergoing truncation of bilateral originating branches of parasympathetic pelvic nerve of major pelvic ganglion (MPG) followed by cystostomy, sham operation group (operation control group, n = 30) undergoing cystostomy, and normal control group (n = 5) not undergoing operation. 3, 7, 11, 15 and > or = 21 days after operation 6 rats from the 2 operation groups and 1 from the control group were sacrificed to observe the gross morphology and histological and cellular changes of the prostate glands.
The prostate of the operation group on post-operational day 7 showed mild granular solidification and such change progressed gradually over time, the ratio of prostate wet weight/rat body weight was (0.4764 +/- 0.0125) mg/g on day 3, then gradually decreased, and became (0.2749 +/- 0.0197) mg/g > or = 21 days post-operationally; while the ratio of prostate tissue dry weight/wet weight on day 3 was (0.1966 +/- 0.0062), then gradually increased, and became (0.2596 +/- 0.0035) > or = 21 days post-operationally. HE staining showed that the glandular structure gradually became dilated and rounded, with accumulation of prostatic fluid. The glandular epithelial cells showed gradual degeneration, necrosis, and detachment. The glandular epithelium became progressively thinner, the smooth muscles elongated and thinned progressively, and the stromal components showed mild to moderate overgrowth. Electron microscopy showed that the glandular cells gradually underwent vacuolar degeneration and the structures of the basement membrane became fuzzy. The smooth muscle cells degenerated mildly, and the fibroblasts and collagenous fibers in the stroma overgrew slowly. All these histological changes were not found in the sham operation control and normal control groups.
Remarkable atrophy occurs in benign hyperplastic prostatic gland after radical removal of the innervation of cholinergic parasympathetic pelvic nerve. Such operation may represent a novel therapy for BPH.
研究胆碱能副交感神经盆神经去神经支配后良性增生前列腺的病理变化。
65只雄性自发性高血压大鼠(SHRs)随机分为3组:手术组(n = 30),行双侧盆神经节副交感盆神经起始分支切断术,随后行膀胱造瘘术;假手术组(手术对照组,n = 30),行膀胱造瘘术;正常对照组(n = 5),未行手术。术后3、7、11、15天及≥21天,处死手术组中的6只大鼠和对照组中的1只大鼠,观察前列腺的大体形态、组织学及细胞变化。
手术组术后第7天前列腺出现轻度颗粒状凝固,且这种变化随时间逐渐进展,术后第3天前列腺湿重/大鼠体重比为(0.4764±0.0125)mg/g,随后逐渐降低,术后≥21天时变为(0.2749±0.0197)mg/g;而术后第3天前列腺组织干重/湿重比为(0.1966±0.0062),随后逐渐升高,术后≥21天时变为(0.2596±0.0035)。苏木精-伊红染色显示腺泡结构逐渐扩张、变圆,前列腺液积聚。腺上皮细胞逐渐变性、坏死、脱落。腺上皮逐渐变薄,平滑肌逐渐伸长、变薄,间质成分呈轻度至中度增生。电子显微镜显示腺细胞逐渐出现空泡变性,基底膜结构模糊。平滑肌细胞轻度变性,间质中的成纤维细胞和胶原纤维缓慢增生。假手术对照组和正常对照组均未发现这些组织学变化。
胆碱能副交感神经盆神经去神经支配后,良性增生前列腺出现明显萎缩。该手术可能是一种治疗良性前列腺增生的新方法。