Growth curves of the fetal prostate based on three-dimensional reconstructions: a correlation with gestational age and maternal testosterone levels

Authors


Andreas Lunacek, Department of Urology, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. e-mail: andreas.lunacek@uibk.ac.at

Abstract

There are two papers in this section this month. The first, by authors from Austria, concerns growth curves of the fetal prostate, correlating gestational age and maternal testosterone using three-dimensional reconstructions. The second, from the UK, investigated testicular microlithiasis, and found no convincing evidence that alone it is a premalignant condition.

OBJECTIVE

To create a nomogram of the fetal growth of the human prostate corresponding to gestational age, and to investigate the relationship between the expansive growth of the fetal prostate and the maternal testosterone surge during pregnancy.

MATERIALS AND METHODS

In all, 27 fetal prostates at 11–40 weeks of gestation, and seven neonatal specimens at 1–20 weeks after birth, were analysed. Serial sections of prostates were immunostained and examined using light microscopy. After modular image acquisition the volumes were calculated using three-dimensional reconstruction. The prostate volumes were correlated with gestational age, and related to reference testosterone levels during pregnancy.

RESULTS

There was exponential growth of the fetal prostate with gestational age. The increasing volume of the prostate during the fetal period corresponded with maternal testosterone levels. In the second trimester there was a significant increase in prostate volume in relation to the bladder. In infants, macroscopically there was an inverse proportion between bladder size and prostate volume.

CONCLUSIONS

Starting from the second trimester there is distinct growth of the fetal prostate, obviously triggered by the maternal testosterone surge. In neonates there is an inversion of the dimensions between bladder and prostate. These results indicating exponential growth of the fetal prostate provide evidence of a gender-related transient infravesical obstruction in human fetuses.

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