Prostate Transition Zone Fibrosis is Associated with Clinical Progression in the Medical Therapy of Prostatic Symptoms (MTOPS) Study

AbstractPurpose:Medications that target androgen receptor activity (e.g., finasteride) or smooth muscle contractility (e.g., doxazosin) do not resolve lower urinary tract symptoms (LUTS) indicative of lower urinary tract dysfunction (LUTD) for an important subgroup of men. Recently, fibrosis has been implicated as another pathobiology contributing to male LUTS, but no systematic studies have been conducted to assess fibrosis within the context of medical treatment. The purpose of this study was to determine whether fibrotic changes in the prostate transition zone (TZ) were associated with an increased risk for clinical progression among participants treated with doxazosin, finasteride, or finasteride+doxazosin in the Medical Therapy of Prostatic Symptoms (MTOPS) study.Methods:TZ biopsy tissues from men who did or did not experience clinical progression on placebo, doxazosin, finasteride, or combination therapy were assessed for collagen content and architectural changes using picrosirius red birefringence...