Prostate development: a historical perspective

The regional anatomy of the human prostate has been debated periodically over the last century with various levels of controversy and agreement, beginning with the concept of lobes and replaced by the current model of zones. During this period a variety of classifications have been proposed, based upon the studies of glandular morphogenesis, responses to hormones or histopathology. The current paradigm suggests that the regional differences seen in the prostate of both animal models and the human are a consequence of specific epithelial-mesenchymal interactions along the cranial-caudal axis of the urogenital sinus. The distinctive regional patterns seen in the rodent prostate and the histological heterogeneity of the human adult gland all point to the modification of the distal portion of the ducts, while the proximal segments retain their spatial relationship to the urethra that was formed during fetal development. This suggests that the early epithelial budding that occurs in utero represents a common, fairly symmetrical pattern of growth in many species, while the regional differences in branching morphogenesis and cytodifferentiation are controlled by the instructional influences of mesenchyme and temporal expression of growth factors. Perturbation of the normal processes involved during critical periods of fetal development during reproductive organ development may also play a role in the susceptibility of the prostate to disease in adulthood. Past descriptions of detailed anatomical studies, which span over a century, have provided much insight into the architecture and processes that form a complex tubulo-alveolar gland. New insights into the ductal detail and the advent of sophisticated analyses of cell-cell interactions and molecular mechanisms controlling pathways of cellular growth, differentiation, and apoptosis will likely lead to new approaches for prevention and therapy of prostatic diseases.