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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.

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Correspondence to Pierre Costa.

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

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Mots clés

  • Hyperplasie bénigne de la prostate
  • andropause, traitement androgénique substitutif

Key Words

  • Benign prostatic hyperplasia
  • aging
  • androgen replacement therapy
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