P–052 Structural and functional changes in the prostate gland of men following orchitis
Authors: Spaska A , Dolynko N 
Published: August 2021

Abstract

Study question
The aim of the study was to establish echometric parameters, hemodynamic and cytohistological changes in the prostate gland in men of reproductive age after orchitis.

Summary answer
After orchitis, volume and mass of the prostate increased compared to the control group, blood flow was reduced, histologically and electron microscopy changes were observed.

What is known already
According to the literature, prostate diseases in men of reproductive age are an important issue in urology and andrology. The most common among them are infectious lesions of the genitourinary system, which constitute about 45%. These include, orchitis, as a part of the infectious process of the entire reproductive system. Half of the cases of orchitis are sexually transmitted infections or associated with infections that come from urogenital tract. In the majority of patients orchitis leads to infertility. But the state of the prostate, under these conditions, remains poorly understood.

Study design, size, duration
We used ultrasound diagnostics and colour ultrasound angiography of the prostate gland of 10 men aged 36–42 years, who suffered from orchitis. The data of 7 healthy men of the same age served as control. For histological and electron microscopy served tissues of prostate gland obtained from the 5 men of the same age group during minor invasive surgery. Statistical processing of the results was carried out using the program Statistica 10. Participants/materials, setting, methods: The length, width, height, volume and mass of the prostate were determined in the grey scale mode. The vascular pattern was determined by colour Doppler mapping (the course of the blood vessels, their diameter, the number in the symmetric sections of prostate). Qualitative hemodynamic indicators: peak systolic blood flow velocity (Vps) cm/s, diastolic blood flow velocity (Vd) cm/s, time average velocity (TAV) cm/s, pulsatility index (PI), volumetric flow rate (V) L/min. Histological methods and TEM.

Main results and the role of chance
After orchitis, the volume of prostate gland increased to (26.0 ± 1.4) cm3 vs (21.2±1.3) cm3 in control and its mass increased to (27.4±1.2) g vs (22.1±1.6) g in control group. The blood flow in the prostate was reduced: peak arterial blood flow velocity in the peripheral zone decreased up to (6.8±0.46) cm/s vs (18.8±3.0) cm/s in control and diastolic blood flow velocity decreased up to (2.75 ± 0.26) cm/s vs (5.7±0.1) cm/s in the control group. The final sections of the glands were cystically enlarged, the squamous epithelium was flattened, the nuclei were pyknotic and the cell borders were indistinguishable. Epithelial folds and shape were preserved, prostatic bodies and acidophilus secretion in the gaps were preserved. The relative volume of the glandular epithelium decreased up to 56.5% and the volume of the fibrous-muscular-elastic component around the lobules increased up to 43.5%. In the capillaries of the prostate, the nuclei of the endothelial cells were deformed, the cytoplasm was vacuolated, the crysts in the mitochondria were reduced, the basement membrane was expanded and uneven. In the nuclei of the prostatic epithelium the perinuclear condensation of chromatin observed, cytoplasm was vacuolated and accumulated drops of fat, the mitochondrial cristae were homogenized.

Limitations, reasons for caution
The results of the investigation approved by the Commission on Biomedical Ethics of the Precarpathian National University as appropriate and those do not violate moral and ethical norms in conducting research (Protocol №3 dated 16.10.2019).
Wider implications of the findings: The results of research indicated changes in the prostate, which require further investigation of hormonal balance in men under these conditions.

Trial registration number
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