Skip to main content
  • Déficit Androgénique Lié à l’Âge
  • Published:

Adénome prostatique, hormones et androgénothérapie

Benign prostatic hyperplasia, hormones and androgen therapy

Résumé

La prostate est androgéno-dépendante. L’adénome prostatique ou hyperplasie bénigne de la prostate (HBP) a une prévalence histologique extrêmement élevée mais tous les hommes porteurs d’une hyperplasie bénigne de la prostate histologique n’en souffrent pas. L’âge et la présence d’androgènes circulants sont les déterminants les plus importants de l’apparition d’une HBP, Toutefois, les taux d’androgènes plasmatiques des hommes porteurs d’une HBP ne sont pas différents de la population générale. La suppression des androgènes provoque une diminution du volume de la prostate. L’administration d’androgènes exogènes est suivie d’une re-croissance prostatique. Mais lors des études sur la substitution androgénique des hommes hypogonadiques, le volume de la prostate n’augmente pas ou peu et semble normal sous traitement. La revue de la littérature permet de penser que l’adénome prostatique ne représente pas une contre-indication à la supplémentation androgénique de l’homme présentant un déficit partiel au total en androgènes. Toutefois la plupart des études ont exclu les hommes porteurs d’une HBP, et une étude spécifique devrait être entreprise.

Abstract

The prostate is an androgen dependent organ. Benign prostatic hyperplasia (BPH) has a high prevalence in histological studies, but all the affected men do not present symptoms. Aging and the presence of androgens are the main determinants of BPH. However, androgen blood levels were not higher in patients with BPH than in the general population. Suppression of androgens induced a decrease in prostatic volume. Androgen replacement therapy resulted in a re-increase of prostatic volume, but during androgen replacement therapy the prostate volume was only slighty increased, it any, thus remaining within normal range.

The present review of the literature indicates that BPH is no a contra-indication for androgen replacement therapy in men with partial or complete androgen deficiency. However, it must be noticed that in most of the studies published so far subjects with BPH have been excluded. A specific study involving such patients is to be undertaken.

Références

  1. BARRY M.J. et al.: Epidemiology and natural history of BPH. Committee 1. In: cockett A.T.K., Khoury S., Aso Y., Chatelain C., Denis L., Griffithe K., Murphy G. eds. The 3rd International Consultation on BPH, 1995: SCI, 1996.

  2. BEHRE H.M.: Prostate volume in treated and untreated hypogonadal men in comparison to age-matched controls. Clin. Endocrinol., 1994, 40: 341–349.

    Article  CAS  Google Scholar 

  3. BEHRE H.M., VON ECKARDSTEIN S., KLIESCH S. et al.: Long-term substitution therapy of hypogonadal men with transscrotal testotosterone over 7–10 years. Clin. Endocrinol., 1999, 50: 629–635.

    Article  CAS  Google Scholar 

  4. BERRY S.J., COFFEY D.S., WALSH P.C., EWING L.L.: The development of human benign prostatic hyperplasia with age. J. Urol., 1984, 132: 474–479.

    PubMed  CAS  Google Scholar 

  5. FRICK J., JUNGWIRTH A., ROVAN E.: Androgens and the prostate. In: Nieschlag E., Behre H.M. eds. Testosterone: action, deficiency, substitution. Berlin, Springer-Verlag, 1998: 259–291.

    Google Scholar 

  6. GRIFFITHS K. et al.: The regulation of prostatic growth. Committee 3. In: Cockett A.T.K., Khoury S., Aso Y., Chatelain C., Denis L., Griffithe K., Murphy G. eds. The 3rd International Consultation on BPH. 1995: SCI 1996.

  7. GOOREN L.J.G.: A ten-years safety study of the oral androgen testosterone undecanoate. J. Androl., 1994, 15: 212–215.

    PubMed  CAS  Google Scholar 

  8. GOOREN L.J.G.: Options of androgen treatment in the aging male. The Aging Male, 1999, 2: 73–80.

    Article  Google Scholar 

  9. HAMMOND G.L.: Serum steroids in normal males and patients with prostatic diseases. Cin. Endocrinol., 1978, 9: 113–121.

    Article  CAS  Google Scholar 

  10. IMPERATO-MCGINLEY J. et al.: Steroid a 5 alpha-reductase deficiency in man: an inherited form of male pseudohermaphorodism. Science, 1974 186: 1213–1215.

    Article  PubMed  CAS  Google Scholar 

  11. JIE-PING W. et al.: The prostate 41–65 years post-castration. An analysis of 26 eunuchs. Chin. Med. J., 1987, 100: 271–272.

    Google Scholar 

  12. KENNY A.M. et al.: Short-term effects of intramuscular and transdermal testosterone on bone turnover, prostate symptoms, cholesterol and hematocrit in men over age 70 with low testosterone levels. Endocrine Res., 26: 153–168.

  13. KIM C.Y. et al.: Endocrine and metabolic aspect including treatment. In Erectile dysfunction. 1 st international consultation on erectile dysfunction. July 1–3, 1999. Paris, Jardin A., Wagner G., Khoury S., Giuliano F., Padma-Nathan H., Rosen R. eds. Plymouth, Health Publication Ltd, Plymbridge Distributors, 2000: 207–240.

    Google Scholar 

  14. LAWSON R K.: Etiology of BPH. In: Lepor H., Lawson R. K. eds. Prostate Diseases. WB Saunders Company, 1993: 89–95.

  15. MOORE R.A.: Benign hypertrophy and carcinoma of the prostate. Occurence and experimental production in animals. Surgery, 1944, 16: 152–167.

    Google Scholar 

  16. MORALES A.: Andropause: androgen therapy and prostate safety. The Aging male, 1999, 2, 81–86.

    Article  Google Scholar 

  17. MORLEY J.E. et al.: Androgen deficiency in aging men: role of testosterone replacement therapy. J. Lab. Clin. Med., 2000, 135: 370–378.

    Article  PubMed  CAS  Google Scholar 

  18. PARTIN A.W. et al.: Influence of age and endocrine factors on the volume of BPH. J. Urol., 1991, 145: 405–409.

    PubMed  CAS  Google Scholar 

  19. SAGNIER P.P. et al.: Inpact of symptoms of prostatism on level of bother and quality of life of men in the french community. J. Urol., 1995, 153: 669–673.

    Article  PubMed  CAS  Google Scholar 

  20. SNYDER P.J., PEACHEY H., BERLIN J.A. et al.: Effects of testosterone replacement in hypogonadal men. J. Clin. Endocrinol. Metab., 2000, 85: 2670–2677.

    Article  PubMed  CAS  Google Scholar 

  21. STONER E.: The clinical effects of a 5 alpha-reductase inhibitor, finasteride, on BPH. The Finasteride study group. J. Urol., 1992, 147: 1298–1302.

    PubMed  CAS  Google Scholar 

  22. STONER E.: Three years safety and efficacy data in the use of finasteride in the treatment of BPH. Urology, 1994, 43: 284–289.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Costa, P. Adénome prostatique, hormones et androgénothérapie. Androl. 12, 133–135 (2002). https://doi.org/10.1007/BF03034958

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03034958

Mots clés

Key Words