[Hormonal disturbances in men with a prostatic adenoma (author's transl)]

On the basis of a series of hormone estimations in elderly men with a prostatic adenoma, and in men not suffering from the condition (old or young), the authors attempt to develop a physiopathological theory of the pathogenesis of prostatic adenoma. The elderly subject not suffering from a prostatic adenoma has lower blood testosterone, DHT (dihydrotestosterone), LH, FSH and oestrogen levels than the elderly subject with an adenoma, whilst the latter has a lower serum progesterone level. In patients with an adenoma, all the urinary metabolites of testosterone are excreted at markedly higher levels than normal. After prostatectomy, mean serum testosterone and DHT levels fall. In patients undergoing surgery for prostatic adenoma there is a higher level of testosterone and DHT in prostatic venous blood than in the peripheral blood. In prostatic adenoma sufferers, the injection of LHRH results in a higher secretion of LH and FSH than in the control group, but this phenomenon caused an increase in testosterone level only in the controls and not in the adenoma patients. Finally, in all patients with a prostatic adenoma in the absence of stimulation by LHRH, blood testosterone levels were proportional to LH levels. Pathogenic hypothesis: the initial phenomenon could be testicular atrophy in the elderly resulting in the active secretion of gonadotrophins, which themselves would cause a hypersecretion of testosterone and its derivatives within the prostatic tissue itself. It remains to obtain evidence of the existence of gonadotrophins receptor in the prostate, the insensitivity of testicular tissue in the elderly subject to increased gonadotrophin levels and the reasons for which the increased secretion of testosterone by adenomatous prostatic tissue does not in its turn induce inhibition of pituitary hypersecretion of gonadotrophins.