Correlation between liver cirrhosis and benign prostatic hyperplasia: a morphological study

In elderly males hormonal changes occur, that are believed to cause benign prostatic hyperplasia (BPH). These are decreased testosterone production, an increased testosterone SHBG and a slightly increased estradiol production. Liver cirrhosis in males causes similar endocrine changes. We carried out a post mortem study evaluating the prostates of 51 men who died with liver cirrhosis compared with a similar group without any hepatic disease. The occurrence of BPH in cirrhotic subjects was diminished and delayed compared to total population. Furthermore in cirrhotic men BPH is more common as early nodular hyperplasia (early stage) or stromal hyperplasia (suggesting estrogenic prevalence), while in the general population stromal and epithelial hyperplasia (androgenic stimulation), were almost equally present.

[The urethral canal in the prostatectomy patient. Echographic aspects]

An evaluation of the urethra has been made in patients who underwent open surgery or endoscopic resection of the prostate, by means of transrectal echography (EG). The technique used is described; studies have been performed both in basal conditions and in various functional phases, including micturation. Echographic findings are compared to those achieved with micturating cystourethrography (MCU). In case of total prostatectomy EG and MCU findings are similar, showing the surgical bladder neck and the urethral aspect even during micturation. EG shows furthermore possible liquid fluid collections. In partial prostatectomies EG and CUM findings differ, showing the first, besides the site of the surgical intervention, the possible presence of calculi, while CUM findings do not differ from those visible in total prostatectomies. Conclusions are that for the whole study of the urethra CUM is necessary, while for the study of the prostatic region EG gives more information. Therefore EG is proposed as method complementary to CUM in the evaluation of the proximal urethra.