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BACKGROUND: Autophagy is a well-conserved catabolic process that plays a key role in cell homeostasis. In the prostate, defective autophagy has been implicated in the genesis and progression of several pathological conditions. AIM: The present review explored the autophagy pathway in prostate-related dysfunctions, focusing on prostate cancer (PCa), benign prostatic hyperplasia (BPH) and prostatitis. RESULTS: Impaired autophagy activity has been shown in animal models of BPH and prostatitis. Moreover, autophagy activation by specific and non-specific drugs improved both conditions in pre-clinical studies. Conversely, the efficacy of autophagy inducers in PCa remains controversial, depending on intrinsic PCa characteristics and stage of progression. Intriguingly, autophagy inhibitors have shown beneficial effects in PCa suppression or even to overcome chemotherapy resistance. However, there are still open questions regarding the upstream mechanisms by which autophagy is deregulated in the prostate and the exact role of autophagy in PCa. The lack of specificity and increased toxicity associated with the currently autophagy inhibitors limits its use clinically, reflecting in reduced number of clinical data. CONCLUSION: New therapeutic strategies to treat prostatic diseases involving new autophagy modulators, combination therapy and new drug formulations should be explored. Understanding the autophagy signaling in each prostatic disease is crucial to determine the best pharmacological approach.

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BACKGROUND: Obesity is associated with increased risk of a number of serious medical conditions, including urological disorders. This study investigated the effect of lipidic extracts of saladette tomato pomace (STP) and Serenoa repens (SR) on the prostate and bladder in a rat obese model induced by high-carbohydrate diet. RESULTS: High-sucrose-fed rats showed higher prostate weight as well as increased contractility and stromal and epithelial hyperplasia in the prostate. Treatment with STP and SR improved contractility and diminished hyperplasia and hypertrophy in the prostate. Obese animals also showed impaired bladder contractility, but neither extract reversed this deterioration. In the histological study, a disarray in the process of smooth muscle cell proliferation with non-parallel fibers was observed; interestingly, treatment with STP and SR led to improvement in this derangement. CONCLUSION: These findings indicated impaired contractility and hyperplasia in the prostate and bladder of obese rats induced by high sucrose. STP and SR could enhance prostate function by reducing contractility and hyperplasia and improve smooth muscle fiber structure and decrease cell proliferation in the bladder, suggesting their possible health-beneficial effects on lower urinary tract symptoms. © 2017 Society of Chemical Industry.

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Senescence is associated with hormonal imbalance and prostatic disorders. Angiogenesis is fundamental for the progression of malignant lesions and is a promising target for prostate cancer treatment. The aim was to characterize matrix metalloproteinase-9 (MMP-9) and insulin-like growth factor receptor-1 (IGFR-1) responses in the prostate during senescence and following antiangiogenic and/or androgen ablation therapies, comparing them to cancer progression features in TRAMP mice. Aged male mice (52-week-old FVB) were submitted to antiangiogenic treatments with SU5416 (6 mg/kg; i.p.) and/or TNP-470 (15 mg/kg; s.c). Finasteride (20 mg/kg; s.c.) was administered alone or associated to both inhibitors. Dorsolateral prostate was collected for light microscopy, and immunohistochemistry and Western blotting collected for MMP-9 and IGFR-1. Senescence led to inflammation and different proliferative lesions in the prostate, as well as to increased MMP-9 and IGFR-1, resembling TRAMP mice prostatic microenvironment. Antiangiogenic therapies promoted recovery and/or interruption of age-associated alterations, presenting differential effects on the molecules studied. SU5416 acted mainly on MMP-9, whereas TNP-470 showed its best influence on IGFR-1 levels. Finasteride administration, alone or in combination with antiangiogenic agents, also resulted in regression of inflammation and neoplastic lesions, besides having a negative modulatory effect on both MMP-9 and IGFR-1. We concluded that stimulated tissue remodeling and proliferative processes during senescence predisposed the prostate to malignant disorders. The combination of different agents was more effective to minimize prostatic imbalance during this period, probably due to the differential action of each drug on factors involved in cell proliferation and extracellular matrix remodeling, resulting in a broader spectrum of effects following the combined treatment.

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Hormonal replacement has been utilized to minimize the harmful effects of hormonal imbalance in elderly men. The development and progression of prostatic diseases and their relation to hormone therapy is still unclear. Thus, the aim herewith was to characterize the structure and dystroglycan molecule (DGs) reactivities in the ventral prostatic lobe from elderly rats submitted to steroid hormone replacement. Male rats (Sprague-Dawley) were divided into one Young group and six senile groups. The Young group (YNG) (4 months old) received peanut oil (5mL/kg, s.c.). The senile rats (10 months old) were submitted to the following treatments: Senile group (SEN) (5mL/kg peanut oil, s.c.); Testosterone group (TEST) (5mg/kg testosterone cipionate, s.c.); Estrogen group (EST) (25µg/kg 17ß-estradiol, s.c.); Castrated group (CAS) (surgical castration); Castrated-Testosterone (CT) (surgical castration and treatment similar to TEST group); and Castrated-Estrogen (CE) (surgical castration and treatment similar to EST group). After 30 days treatment, blood samples were collected for hormonal analysis and ventral prostate samples were processed for light and transmission electron microscopies, morphometrical analysis, immunohistochemistry and Western Blotting. The results showed decreased serum testosterone levels in the senescence and increased testosterone and estrogen plasmatic levels after hormone administration in the TEST and EST groups, respectively, highlighting the therapy efficiency. Hypertrophied stroma and inflammatory cells were verified in the SEN group. After hormone replacement in the senescence or following castration, atrophic epithelium, epithelial cells with clear cytoplasmic halo around the nucleus, microacini and maintenance of hypertrophied stroma were seen. Decreased DG levels were verified in the senescence. After hormonal therapy, increased protein levels of these molecules were observed, especially in those groups which received estradiol. Thus, the occurrence of inflammatory cells, stromal hypertrophy and the presence of cells with clear halo around the nucleus after hormonal therapy probably indicated prostatic paracrine signaling imbalance, suggesting a stromal reactive microenvironment favorable to the development of glandular lesions. However, the increase of DG levels characterized positive effect of steroid hormone replacement on the prostate in the senescence. Thus, it could be concluded that despite having positive effects on important molecules involved in the maintenance of epithelial-stromal interaction and glandular cytoarchitecture, such as DGs, hormonal therapy enhanced structural changes associated with senescence, probably due to increased hormonal imbalance between androgens and estrogens in the prostatic tissue.

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OBJECTIVE: Primary prostatic tuberculosis is a very rare form of presentation of the tuberculous infection, which is generally caused by the M. tuberculosis, and which has shown an increase in incidence and prevalence, due to an increase of immunocompromised patients and the pandemic of the Syndrome of Acquired Immune Deficiency (AIDS).We describe a case of primary prostatic tuberculosis attended at the Hospital Universitario de Santander, Colombia, and to perform a discussion about this topic. METHODS/RESULTS: 65 year old man who consulted with symptoms of frequency, dysuria and hesitancy, and 10 Kg weight loss in the last 6 months, without pulmonary symptoms and negative ELISA test for HIV. On physical examination there was evidenceof the presence of a high volume, irregular and hard prostatic gland. That is why a prostatic Doppler ecography was performed showing a prostatic volume of 39 cm3, without sign of malignity. Biopsy of the prostatic gland showed multiple granulomas and the ZN staining was positive for mycobacteria. With these findings the diagnosis of primary prostatic tuberculosis was established, and treatment was carried out and now the patient is asymptomatic with no evidence of active tuberculosis. CONCLUSIONS: Primary prostatic tuberculosis without history or evidence of commitment of the immune system is a very rare condition, nevertheless, it is particularly important to know it due to the progressive increase of its presentation and the possibility of a curative treatment to affected patients.

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CONTEXT: Tuberculosis of the prostate has mainly been described in immunocompromised patients. However, it can exceptionally be found as an isolated lesion in immunocompetent patients. CASE REPORT: We report a case of prostatic tuberculosis in a young, healthy and immunocompetent patient with unremarkable findings from intravenous urographic examination. Computed tomography showed an abscess in the prostate and Mycobacterium tuberculosis was isolated in a urine culture. Treatment with isoniazid, rifampin and pyrazinamide was successful.

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CONTEXT: Tuberculosis of the prostate has mainly been described in immunocompromised patients. However, it can exceptionally be found as an isolated lesion in immunocompetent patients. CASE REPORT: We report a case of prostatic tuberculosis in a young, healthy and immunocompetent patient with unremarkable findings from intravenous urographic examination. Computed tomography showed an abscess in the prostate and Mycobacterium tuberculosis was isolated in a urine culture. Treatment with isoniazid, rifampin and pyrazinamide was successful.

CONTEXTO: La tuberculosis prostática ha sido principalmente descrita en pacientes inmunodeprimidos. Sin embargo, es excepcional como lesión aislada en pacientes inmunocompetentes. CASO CLINICO: Describimos el caso de un varón sano e inmunocompetente con tuberculosis prostática y hallazgos irrelevantes en la urografía de eliminación realizada. La tomografía computerizada (TC) mostró un absceso en próstata, aislándose en el urocultivo Mycobacterium tuberculosis. El tratamiento con isoniazida, rifampicina y pirazinamida fue exitoso.

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A segunda parte dessa revisão abordará as alterações prostáticas em cães. Nela, não serão comentadas as alterações nas glândulas sexuais acessórias dos gatos, pois se tratam de enfermidades raras. As enfermidades prostáticas são mais comuns em cães idosos e as principais alterações relacionadas ao tecido prostático são: hiperplasia/ hipertrofia prostática benigna, prostatites (aguda ou crônica), abscessos prostáticos, cistos prostáticos e paraprostáticos, neoplasias e metaplasia escamosa(AU)

The part II of this review will approach the prostate diseases in dogs. In this part, diseases on accessory sexual glands of the cats will not be reviewed, therefore they are uncommon diseases. The prostate diseases are common in aged dogs and the main alterations related to the prostatic tissue are: benign prostatic hypertrophy/hyperplasia, prastatitis (acute or chronic), abscesses, prostatic and paraprostatic cysts, neoplasia and squamous metaplasia(AU)

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A segunda parte dessa revisão abordará as alterações prostáticas em cães. Nela, não serão comentadas as alterações nas glândulas sexuais acessórias dos gatos, pois se tratam de enfermidades raras. As enfermidades prostáticas são mais comuns em cães idosos e as principais alterações relacionadas ao tecido prostático são: hiperplasia/ hipertrofia prostática benigna, prostatites (aguda ou crônica), abscessos prostáticos, cistos prostáticos e paraprostáticos, neoplasias e metaplasia escamosa

The part II of this review will approach the prostate diseases in dogs. In this part, diseases on accessory sexual glands of the cats will not be reviewed, therefore they are uncommon diseases. The prostate diseases are common in aged dogs and the main alterations related to the prostatic tissue are: benign prostatic hypertrophy/hyperplasia, prastatitis (acute or chronic), abscesses, prostatic and paraprostatic cysts, neoplasia and squamous metaplasia

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Este artículo tiene como objetivo primordial analizar el por que de cada recomendación que se le da a los pacientes masculinos en general, aunado a las recomendaciones de Suplemento Nutricional Prostático y/o Quimioprevención del Cáncer Prostático, sobre todo en poblaciones de alto riesgo de padecer un cáncer prostático (afroamericano, hijos de pacientes que han padecido cáncer prostático, pacientes con niveles séricos elevados de PSA total (por arriba de 2.5 ng/ml, o con alteraciones de cualquier otra fracción del PSA), incluyendo anormalidades de los índices oncológicos de la ecosonografía prostática endorrectal, pacientes con lesiones premalignas de cáncer prostático como el PIN (neoplasia intraepitelial prostática) de alto grado, la Hipertensión Adenomatosa Atípica (HAA), obtenidas en biopsias prostáticas por trucul, o en biopsias de prostatas resecadas o extirpadas quirúrgicamente (RTUP) o prostatectomías abiertas por presentar crecimiento prostático benigno sintomático (CPB), cosiderando todos los argumentos terapéuticos que están a nuestro alcance (agentes químicos sintétidos o naturales contenidos en los alimentos, raices o plantas) para reducir o inclusive eliminar con las recomendaciones analizadas y con el suplemento nutricional prostático, los síntomas urinarios de llenamiento y de vaciamiento vesical (irritativos- obstructivos) y con ello mejorar los cuestionarios de calidad de vida dependiendo de los síntomas urinarios molestos

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La hiperplasia prostática benigna (HPB) es un problema común en el varón senil. La HPB es el crecimiento prostático estromal-glandular en varones con un efecto testicular hormonal asociado con la edad y que produce obstrución urinaria conocida como prostatismo. 50 por ciento de varones con evidencia histológica de HPB evolucionarán a una obstrucción clínica y 25 por ciento tendrá que recibir algún tipo de tratamiento para sus síntomas. Este estudio valoró hombres con prostatismo asociado a HPB con un bajo volumen de zona transicional (ZT), y la utilidad de la incisión transuretral de próstata (ITUP), al compararse con varones en vigilancia y otros que recibieron tratamiento con bloqueadores alfa. Material y métodos. Doce hombres fueron sometidos a ITUP después de evaluación con la puntuación de la AUA, índice de calidad de vida y tasa de flujo máximo y se compararon los resultados con 10 pacientes que recibieron bloqueadores alfa y otro grupo de 10 pacientes que se vigilaron en un tiempo de 24 semanas, cada grupo con una ZT prostática de 15 cc o menor. Resultados. Los pacientes sometidos a ITUP obtuvieron los beneficios de esta modalidad incrementando la tasa de flujo máximo 4.93 ml/s, los pacientes con bloqueadores alfa incrementaron 4.36 ml/s, y los pacientes vigilados sólo incrementaron 1.8 ml/s, la puntuación de la AUA disminuyó 10.4 puntos en los pacientes sometidos a ITUP, en los pacientes con bloqueadores alfa disminuyó 3.8 puntos y en los pacientes vigilados se incrementó 1.5, el índice de calidad de vida disminuyó 2.5 puntos en los pacientes sometidos a ITUP, 1.6 en los que recibieron bloqueadores alfa y 0.2 en los pacientes vigilados. Conclusiones. La ITUP es una excelente alternativa de tratamiento de la BPB con bajo volumen de ZT (< de 15 cc), con buenos resultados a mediano plazo valorando lo anterior con la puntuación de síntomas de la AUA, índice de calidad de vida y tasa de flujo máximo

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