Role of the prostatic stroma in UCPPS

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Inflamm Res. 2009 Sep 11. [Epub ahead of print]

The role of the prostatic stroma in chronic prostatitis/chronic pelvic pain syndrome.

Dellabella M, Milanese G, Sigala S, d'Anzeo G, Arrighi N, Bodei S, Muzzonigro G.
Department of Clinic and Specialistic Sciences-Urology and Andrology, Polytechnic University of the Marche Region, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I-G.M. Lancisi-G. Salesi, via Conca 71, 60100, Ancona, Italy, [email protected].

OBJECTIVE: To confirm the hypothesis of prostatic stromal involvement in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

MATERIALS AND METHODS: A literature review to analyze mechanisms commonly indicated as a cause of CP/CPPS that can interfere with the processes of cell growth of smooth muscle fibrocells and may cause smooth muscle cell hypertrophy, periurethral edema, and inflammation.

RESULTS: Our review strongly suggests a prevalent stromal involvement, specifically of the smooth muscle cells, in CP/CPPS physiopathology. The involvement of the endocrine system, in particular the role of estrogens, the neurological pathway mediated by noradrenalin, and the presence of inflammation, support the hypothesis that CP/CPPS could be a disease with a prevalent role of smooth muscle stromal cells rather than glandular structures. Neurogenous inflammation, oxidative stress and psychological factors may be involved in the chronic nature of the disease.

CONCLUSIONS: We believe that new studies regarding chronic prostatitis should also be focused on prostatic stromal involvement in the inflammatory pathway.

PMID: 19757087