Prostate Volume, Size Does Matter. Growth Dynamics of the Acini and the Stroma using a “Prostatocrit” Model-JOJ Urology & Nephrology-Juniper Publishers

JUNIPER PUBLISHERS-JOJ Urology & Nephrology

Prostate Volume, Size Does Matter. Growth Dynamics of the Acini and the Stroma using a “Prostatocrit” Model

Authored by Simon Robinson*

Analysis of prostatic growth has focused on the whole gland volume. However there are distinct zones which grow at different rates which can be further divided into acini and stroma. Measuring the principal sub-zones of the gland and taking into account their intrinsic asymmetry of glandular acina density, one can develop the prostatocrit model, similar to the haematocrit. This generates four new zones which better define the differential growth of the gland. This has implications for benign and malignant glands, response to drugs and need for surgery. Retrospective data was collected from 409 men undergoing TRUS and biopsy in a district general hospital. Whole gland and zonal volumes were recorded along with IPSS scores. Rates of growth for conventional and prostatocrit volumes were compared using univariate analysis. The relative amount of PSA secretion per zone was estimated using the model. The PSA densities and ratio of zone to whole gland were plotted. Univariate analysis to measure slopes of rate of growths of zones and relation to PSA. Multivariate analysis was used to find significant predictors of PSA secretion. IPSS scores of whole gland and zones. ts and limitations: Age (P<0.0001) and the transition zone stromal volume (P=0.0001) were the only significant factors for PSA secretion. None of the conventional volumes were included in the model. Limitations include TRUS estimations are probably inferior to MRI. Some negative biopsies will prove to have missed cancer. This new prostatocrit model is consistent with known gross and microscopic anatomical differences in the gland. It potentially reveals a more logical, intuitive and easily measured account of the zonal and sub-zonal growth patterns.

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