Angrimani D S R, Silvestrini G R, Brito M M, Abreu R A, Almeida L L, Vannucchi C I
Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Orlando Marques de Paiva, 87 -05508-270 São Paulo, Brazil.
Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Orlando Marques de Paiva, 87 -05508-270 São Paulo, Brazil.
Theriogenology. 2018 Jul 1;114:103-108. doi: 10.1016/j.theriogenology.2018.03.031. Epub 2018 Mar 27.
Benign prostatic hyperplasia (BPH) is characterized by an enlargement of the prostate accompanied by an increase in prostatic blood perfusion and vascularization. The most indicated treatment is to perform orchiectomy, however, medical treatment with finasteride can be an option for breeding dogs or elderly animals with a critical health status. In dogs, the influence of medical treatment on prostatic hemodynamics is still unknown. Therefore, this study aimed to evaluate the effects of benign prostatic hyperplasia and finasteride therapy on hemodynamic and vascular features of the canine prostate. For this purpose, twenty dogs of different breeds, body weights (10-30 kg) and ages (5-13 years) were used, assigned for: Healthy-non treated group (n = 5), BPH-non treated group (n = 5), Healthy-finasteride treated group (n = 5) and BPH-finasteride treated group (n = 5). Dogs that presented hematospermia and at least one general clinical sign (tenesmus, hematuria or dysuria) were presumptively diagnosed with BPH. Dogs were evaluated ultrasonographycally by B-mode and Doppler of the prostatic artery in a monthly interval (day 0, 30 and 60) in order to measure prostate volume (PV), expected prostate volume (EPV), prostate vascularization score (scored as minimum, intermediary and maximum) and prostatic artery blood flow parameters with the use of spectral and color Doppler ultrasound. It was possible to observe a decrease in prostate vascularization score between Day 0 (intermediary degree) and 60 (minimum degree) in finasteride treated dogs. Moreover, non-treated dogs had higher score of vascularization at Day 60 compared to animals treated with finasteride, regardless of BPH diagnosis. Healthy-non treated animals presented higher peak systolic:diastolic velocity (S/D) than BPH-non treated dogs. Furthermore, BPH-non treated dogs had lower S/D than BPH-finasteride treated dogs. In 30 and 60 days, no difference on PV was observed between BPH-finasteride treated group and Healthy-non treated group. At day 60, no difference between PV and EPV was observed for the BPH-finasteride treated group. In conclusion, finasteride treatment reduces simultaneously the volume, local vascularization and blood flow of the prostate, thus, being considered an effective and additional choice of therapy for BPH. Moreover, the course of therapy in dogs can be followed by analyzing changes in prostatic artery.
良性前列腺增生(BPH)的特征是前列腺增大,同时伴有前列腺血液灌注和血管生成增加。最常用的治疗方法是进行睾丸切除术,然而,对于种公犬或健康状况不佳的老年动物,使用非那雄胺进行药物治疗也是一种选择。在犬类中,药物治疗对前列腺血流动力学的影响尚不清楚。因此,本研究旨在评估良性前列腺增生和非那雄胺治疗对犬前列腺血流动力学和血管特征的影响。为此,使用了20只不同品种、体重(10 - 30千克)和年龄(5 - 13岁)的犬,分为:健康未治疗组(n = 5)、BPH未治疗组(n = 5)、健康非那雄胺治疗组(n = 5)和BPH非那雄胺治疗组(n = 5)。出现血精且至少有一项一般临床体征(里急后重、血尿或排尿困难)的犬被初步诊断为BPH。每隔一个月(第0、30和60天)通过B超和前列腺动脉多普勒超声对犬进行评估,以测量前列腺体积(PV)、预期前列腺体积(EPV)、前列腺血管生成评分(分为最低、中等和最高)以及使用频谱和彩色多普勒超声测量前列腺动脉血流参数。可以观察到,在非那雄胺治疗的犬中,第0天(中等程度)到第60天(最低程度)前列腺血管生成评分有所下降。此外,无论是否诊断为BPH,未治疗的犬在第60天时的血管生成评分均高于接受非那雄胺治疗的动物。健康未治疗的动物比BPH未治疗的犬具有更高的收缩期峰值:舒张期速度(S/D)。此外,BPH未治疗的犬的S/D低于BPH非那雄胺治疗的犬。在第30天和第60天,BPH非那雄胺治疗组和健康未治疗组之间在PV上未观察到差异。在第60天,BPH非那雄胺治疗组的PV和EPV之间未观察到差异。总之,非那雄胺治疗可同时减少前列腺的体积、局部血管生成和血流量,因此被认为是BPH的一种有效且额外的治疗选择。此外,通过分析前列腺动脉的变化可以跟踪犬的治疗过程。