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THE PATHOGENESIS OF BENIGN PROSTATIC HYPERPLASIA: A PROPOSED HYPOTHESIS AND CRITICAL EVALUATION

1998; Lippincott Williams & Wilkins; Volume: 160; Issue: 6 Part 2 Linguagem: Inglês

10.1016/s0022-5347(01)62195-5

1527-3792

John T. Grayhack, James M. Kozlowski, CHUNG LEE,

Prostate Cancer Diagnosis and Treatment

No AccessJournal of UrologyFestschrift in Honor of 85th Birthday of Dr. William Wallace Scott, Sr1 Dec 1998THE PATHOGENESIS OF BENIGN PROSTATIC HYPERPLASIA: A PROPOSED HYPOTHESIS AND CRITICAL EVALUATION JOHN T. GRAYHACK, JAMES M. KOZLOWSKI, and CHUNG LEE JOHN T. GRAYHACKJOHN T. GRAYHACK More articles by this author , JAMES M. KOZLOWSKIJAMES M. KOZLOWSKI More articles by this author , and CHUNG LEECHUNG LEE More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)62195-5AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We used expanding observations regarding effects of testicular epididymal plasma and nonandrogenic testis factor(s) (NATF) on prostate growth to propose and evaluate a hypothesis regarding the development of benign prostatic hyperplasia (BPH) in man. Materials and Methods: Current experimental data regarding the presence of NATF were reviewed. The potential for their exposure to the prostate by various routes was assessed. These observations were coupled with recognized anatomical, histological and epidemiological characteristics of BPH to construct a hypothesis regarding its pathogenesis. Results: In vivo observations in man, rats and dogs supported the systemic secretion of NATF. These factors probably are, at least in part, spermatogenesis related. In vitro evaluation of the effect of spermatocele derived testicular epididymal plasma on human prostate stromal cells indicated the presence of androgen independent and androgen synergistic stromal growth promoters. These factors have potential local and systemic access to the prostate. The almost ubiquitous development of a regional, histologically variegated nodular growth occurring in the prostate in the androgen diminished environment of the aging man is compatible with local as well as systemic exposure to an age associated secretion of NATF. Conclusions: We propose that human BPH is an induced phenomenon that is usually initiated by local episodic exposure of periurethral prostate to mitogens secreted by the testis/epididymis. Once initiated, isolated or complex interacting proliferative stimuli from the testis/epididymis and a variety of other sources may achieve exposure to the prostate by several routes and stimulate prostate growth. References 1 : Intrinsic and extrinsic factors controlling benign prostatic growth. Prostate1997; 31: 131. Google Scholar 2 : Effect of spermatocele fluid on growth of human prostatic cells in culture. J. Androl.1993; 14: 233. 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Chicago Ave., Tarry Bldg., Room 11-723, Chicago, Illinois 60611.© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byGRAYHACK J, SMITH N, ILIO K, WAMBI C, KASJANSKI R, CRAWFORD S, DOLL J, WANG Z, LEE C and KOZLOWSKI J (2018) Pigment Epithelium-Derived Factor, a Human Testis Epididymis Secretory Product, Promotes Human Prostate Stromal Cell Growth in CultureJournal of Urology, VOL. 171, NO. 1, (434-438), Online publication date: 1-Jan-2004. Volume 160Issue 6 Part 2December 1998Page: 2375-2380 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.Keywordsprostatic hypertrophytestisepididymisplasmaMetrics Author Information JOHN T. GRAYHACK More articles by this author JAMES M. KOZLOWSKI More articles by this author CHUNG LEE More articles by this author Expand All Advertisement PDF downloadLoading ...