Estudo da estrutura da fáscia endopélvica em pacientes com diferentes pesos prostáticos

Abstract

The objective of this paper is to study the structure of the endopelvic fascia in prostates of different weights. We studied 10 patients with BPH (54 to 82 years old, mean=67.7 prostates >90g); 10 patients with prostate adenocarcinoma (PAC) (56 to 70 years old, mean=64 prostates <60g) and 5 young male cadavers (17 to 30 years-old, mean=24.4 control group). During the surgery, the endopelvic fascia was dissected and a small sample was obtained. The samples were stained with Masson s Trichrome (to quantify smooth muscle cells - SMC); Weigert Resorcin Fuchsin (elastic fibers) and PicroSirius red with polarization and immunohistochemical analysis of the type III collagen fibers to observe collagen. The images were captured with an Olympus BX51 microscope and Olympus DP70 camera. The morphometric analysis was done with the Image Pro and Image J programs, using a grid to determine areal densities. Means were statistically compared using the one-way ANOVA with the Bonferroni test and a p-value < 0.05 was considered statistically significant.The mean of the prostate weight was 122 g in BPH patients, 42.3g in PAC patients and 18.6g in control group. Quantitative analysis documented there are no differences (p=0.19) in the areal density of elastic fibers and in the areal density of type III collagen (p=0.88) between the three groups. There was a significant difference (p=0<0.0001) in the quantification of SMC in patients with prostates >90g (mean=9.61%) when compared to patients with prostates <60g (mean =17.92%) and with the control group (mean=33.35%). We observed some important differences in endopelvic fascia structure in prostates >90g, which can be an additional factor for pre-operatory evaluation of radical prostatectomy.