Benign prostatic hyperplasia (BPH) is a common disease of aging men and the development of lower urinary tract symptoms (LUTS) secondary to BPH is believed to be caused by both a static and dynamic component to bladder outflow obstruction (BOO). The static component is attributed to the mass effect of the enlarged adenoma, whereas the dynamic component is related to the smooth muscle tone within the prostate. The prostate is a heterogeneous organ and comprises three distinct anatomical "zones". The formation of stromal and glandular nodules is the histological hallmarks of BPH and occurs in the transition zone. The mechanical properties of benign prostate tissue obtained from transurethral resection (TURP) have been shown to reflect the underlying morphology with respect to smooth muscle content. To further investigate the structure-property relationship in benign prostate tissue, specimens from TURP and whole prostates from cystoprostatectomy were examined. The use of transverse sections of the whole gland allowed morphometric and mechanical studies to be performed in all regions of the prostate. A novel method of morphometric analysis representative of the local area of tissue that was subjected to mechanical testing was developed. Significant correlations were shown between the mechanical and morphological properties of glandular and stromal nodules. Glandular nodules may contribute to the pathophysiology of BPH by altering the dynamic characteristics of the prostate in addition to producing a mass effect. In parallel to the above aforementioned work in whole prostates, the effect of quinazoline and non-quinazoline based alpha-blockers upon prostate tissue obtained from TURP was examined. This work also investigated whether alpha blocker therapy influenced the mechanical measurements by their action within the prostate tissue. Significant correlations were shown between alpha blocker therapy and the underlying morphology and this is reflected in the mechanical measurements. These studies provide a greater understanding of the structure-property relationships within prostate tissue and it is likely that assessment of the mechanical properties of the prostate will be useful in the clinical evaluation and management of patients with benign prostate disease.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:726483 |
| Date | January 2013 |
| Creators | Leung, Steve Ken Wing |
| Publisher | University of Edinburgh |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://hdl.handle.net/1842/24827 |
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