Epithelial regression and decrease in serum PSA levels induced by short-term doxazosin treatment in benign prostatic hyperplasia


Türkeri L. , ÖZYÜREK M., Venice S., Ersev D.

British Journal of Urology, vol.80, pp.209, 1997 (Journal Indexed in SCI Expanded) identifier

  • Publication Type: Article / Article
  • Volume: 80
  • Publication Date: 1997
  • Title of Journal : British Journal of Urology
  • Page Numbers: pp.209

Abstract

Benign enlargement of the prostate comprises both hypertrophy and in particular hyperplasia of prostatic stromal and glandular compartments. Alpha adrenergic blockade has been shown to be effective in management of BPH. A total of 29 patients who were symptomatic due BPH were enrolled into this prospective placebo controlled, double-blind study. Drug treatment was followed by prostatectomy at the end of 4th week. Clinical efficacy was evaluated by a scoring system with use of uroflowmetry, post-void residuals, symptom scoring, serum PSA levels and volume determination by transrectal ultrasound. Surgical specimens were analyzed by immunohistochemistry and tissue components of stroma, smooth muscle and glandular epithelium were calculated by a software on a computer after representative areas were scanned and captured as high resolution images. Each image processed digitally to exaggerate the contrast between the glandular epithelium and stroma and calculated by the software. There was a steady decline in patients' urinary complaints as evidenced by symptom score in Doxazosin group compared to placebo (30.8% versus 17% reduction from baseline, respectively). Uroflowmetric investigations on patients revealed that maximum flow rates in active drug group increased throughout the study. Mean PSA levels decreased by 14% at the end of the study in doxazosin group where it was increased by 11% in the placebo group. In relation to this, percent area occupied by stroma was 1.5 times larger in doxazosin group. Average stroma to epithelial ratio in doxazosin group was 2.1 in comparison to a value of 1.1 in placebo group. The average percentage of epithelium and related luminal space was 54.5 in and 70.3, respectively in these groups. Our data suggest an increase in the percentage of stroma by doxazosin treatment coupled with a decrease in average PSA levels. This is also accompanied by a decrease percent area of epithelium and epithelial luminal space in comparison to placebo indicate glandular regression generated by α-adrenergic blockade.