Morphologic and regulatory aspects of prostatic function.

Current concepts of the structural and functional organization of the human prostate are presented and are related to endocrine principles which have been studied in experimental animals. Based on embryological and histological studies, the internal structure of the human prostate gland is divided into four subdivisions: 1. the anterior nonglandular fibromuscular stroma. 2. the periurethral portion, 3. the peripheral zone, and 4. the central zone. The central zone which accounts for 25% of the gland, is formed by a wedge-shaped group of ducts, arising close to the orifices of the ejaculatory ducts and is surrounded by the peripheral zone (75% of the gland). The functional interdependence and relationship between the stroma and the epithelium observed during embryological development, postnatal maturation and under certain pathological conditions, has led to the concept of a functional prostatic unit, which is useful for the explanation of prostatic growth and the expression of specific genes. There is growing evidence of a functional heterogeneity within the prostatic secretory duct system, with a concentration of estrogen-sensitive cells close to the urethra, and a relatively long persistence of undifferentiated nonsecretory acini at the peripheral tips of the gland ducts close to the dorsal capsule until late puberty. Secretory and proliferative activities of the gland are strictly androgen-dependent. Of particular importance with respect to glandular and stromal proliferation are the recent reports on the presence of different growth factors in the prostate. Hormonally induced imbalances in the system of growth factor production, androgen- and estrogen-dependence and general ageing of the cells have to be taken into consideration in understanding various prostatic pathologies such as benign prostatic hyperplasia and prostate cancer.