[Prostatism in patients with chronic renal failure and in renal transplant recipients. Comparative study]

Though hypogonadism is part of the clinical picture of chronic renal failure, its etiology remains unknown. Because of the consequences it may have on the prostate gland, it was decided to conduct a prospective evaluation on its influence on prostatic signs and symptoms and glandular growth in a group of patients with chronic renal failure undergoing dialysis and a second group with renal transplantation. To this end, the presence of symptoms was assessed in 78 subjects over 50 years of age: 22 healthy controls (group C) (28.2%), 28 in haemodialysis (Group HD) (35.0%) and 28 with renal transplantation (Group RT) (35.9%). All subjects were aged between 53 and 80 years (mean 58.29 +/- 5.45). Determination of degree of prostatism was done by the International Prostate Symptoms Score (IPSS-S and L), flowmetry, ultrasound postmictional residue, transrectal ultrasound with 3 prostatic diameters (cross-sectional, antero-posterior and longitudinal), prostate weight and plasma levels of PSA, testosterone, FSH, LH, PRL and oestradiol. In 26 of 28 patients in the HD group IPSS-L, flowmetry and post-mictional residue was not assessed as they had no spontaneous miction. There were significant differences in IPSS between C and RT (p = 0.003), Qmax between C and RT (p = 0.009), post-mictional residue between C and RT (p = 0.045), cross-sectional diameter between C and HD (p = 0.036), prostate weight between C and HD (p = 0.001), and between HD and RT (p = 0.001), PSA between C and RT (p = 0.026), FSH between C and HD (p = 0.005), LH between HD and RT (p = 0.020), PRL between HD and RT (p = 0.023), Oestradiol between C and HD (p = 0.032). We conclude that hypogonadism is a factor which, in patients with chronic renal failure and renal transplantation, contributes to prevent prostate growth thus minimizing the symptoms of prostatism.