Prostatic hyperplasia in acromegaly, a myth or reality: a case-control study
Santosh Kumar1, Ram Niwas Yadav1, Prakamya Gupta1
1Departments of UrologyGeneral SurgeryNeurosurgeryHistopathologyEndocrinologyPostgraduate Institute of Medical Education and Research, 4th Floor, F Block, Nehru Hospital, Chandigarh 160012, IndiaBarts and the London School of MedicineWilliam Harvey Research Institute, Queen Mary University, London EC1M6BQ, UK.
European Journal of Endocrinology
|January 1, 2015
Summary
Men with acromegaly show increased prostate size and urinary symptoms compared to healthy individuals. This is linked to the growth hormone-insulin-like growth factor 1 (IGF1) axis, regardless of hormone levels or disease activity.
Area of Science:
- Endocrinology
- Urology
- Pathology
Background:
- Acromegaly is associated with a higher prevalence of prostate disorders.
- The growth hormone-insulin-like growth factor 1 (GH-IGF1) axis significantly influences prostate growth and development.
Purpose of the Study:
- To investigate the correlation between structural and histopathological prostate changes and prostatic symptoms in acromegaly patients.
- To assess the role of the GH/IGF1 axis in these prostate alterations.
Main Methods:
- A case-control study was conducted with 53 men with acromegaly and 50 healthy controls.
- Evaluated International Prostate Symptom Score (IPSS), prostate-specific antigen (PSA), trans-rectal ultrasonography, uroflowmetry, and prostatic tissue biopsy with anti-IGF1 immunopositivity.
Main Results:
- Acromegaly patients exhibited higher IPSS, PSA levels, and obstructive features on uroflowmetry, alongside larger prostate dimensions, despite lower testosterone.
- Prostatic hyperplasia was observed in 42.8% of acromegaly patients with biopsies, with moderate IGF1 positivity.
- Controls showed mild IGF1 positivity in benign cases and variable positivity in malignancies.
Conclusions:
- Patients with acromegaly demonstrate a higher incidence of prostate structural changes, increased prostatic volume, and obstructive symptoms compared to controls.
- These prostate changes in acromegaly are independent of age, gonadal status, and disease activity.
