Androgen Deprivation Accelerates the Prostatic Urethra Wound Healing After Thulium Laser Resection of the Prostate by Promoting Re-Epithelialization and Regulating the Macrophage Polarization.
BACKGROUND
Complications after a thulium laser resection of the prostate (TmLRP) are related to re-epithelialization of the prostatic urethra. Since prostate growth and development are induced by androgen, the aim of this study was to determine the role and explore the mechanism of androgen in wound healing of the prostatic urethra.


METHODS
Beagles that received TmLRPs were randomly distributed into a castration group, a testosterone undecanoate (TU) group, and a control group. The prostate wound was assessed once a week using a cystoscope. Histological analysis was then carried out to study the re-epithelialization of the prostatic urethra in each group. The inflammatory response in the wound tissue and urine was also investigated.


RESULTS
The healing of the prostatic urethra after a TmLRP was more rapid in the castration group and slower in the TU group than that in the control group. Castration accelerated re-epithelialization by promoting basal cell proliferation in the wound surface and beneath the wound and by accelerating the differentiation of basal cells into urothelial cells. Castration reduced the duration of the inflammatory phase and induced the conversion of M1 macrophages to M2 macrophages, thus accelerating the maturation of the wound. By contrast, androgen supplementation enhanced the inflammatory response and prolonged the inflammatory phase. Moreover, the anti-inflammatory phase was delayed and weakened.


CONCLUSIONS
Androgen deprivation promotes re-epithelialization of the wound, regulates the inflammatory response, and accelerates wound healing of the prostatic urethra after a TmLRP. Prostate 77:708-717, 2017. © 2017 Wiley Periodicals, Inc.
Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Xing-Jie
XJ
Wang
Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Department of Urology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.|Institute of Urology, Shanghai Jiao Tong University, Shanghai, China.
Jian
J
Zhuo
Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
Guang-Heng
GH
Luo
Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yi-Ping
YP
Zhu
Department of Urology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.|Department of Urology, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo, China.
Dian-Jun
DJ
Yu
Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Rui-Zhe
RZ
Zhao
Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Chen-Yi
CY
Jiang
Department of Urology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.|Department of Urology, Wujin Hospital Affiliated Jiang Su University, Changzhou, China.
Yun-Feng
YF
Shi
Department of Urology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.|Department of Urology, General Hospital of Xuzhou Mining Group, Xuzhou, China.
Hao
H
Li
Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Lei
L
Chen
Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Kui-Yuan
KY
Hao
Department of Urology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.
Xia
X
Han
Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Sheng
S
Zhao
Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Xiao-Yu
XY
Bei
Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Institute of Urology, Shanghai Jiao Tong University, Shanghai, China.
Yi-Feng
YF
Jing
Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|Institute of Urology, Shanghai Jiao Tong University, Shanghai, China.
Shu-Jie
SJ
Xia
D000728:Androgens / Q000008:administration & dosage / Q000009:adverse effects / Q000378:metabolism; D000818:Animals; D004195:Disease Models, Animal; D004285:Dogs; D007431:Intraoperative Complications / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy; D008264:Macrophages / Q000473:pathology / Q000502:physiology; D008297:Male; D011467:Prostate / Q000473:pathology / Q000601:surgery; D062326:Re-Epithelialization / Q000187:drug effects / Q000502:physiology; D013223:Statistics as Topic; D013739:Testosterone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000378:metabolism; D013932:Thulium / Q000494:pharmacology; D020728:Transurethral Resection of Prostate / Q000009:adverse effects* / Q000379:methods; D014521:Urethra / Q000293:injuries / Q000473:pathology; D014945:Wound Healing / Q000187:drug effects / Q000502:physiology
D000728:Androgens; D013739:Testosterone; D013932:Thulium; C010792:testosterone undecanoate
androgen; basal cell; benign prostatic hyperplasia; macrophage; wound healing