Benign Prostatic Hyperplasia and Prostate Cancer

Pathophysiology of Benign Prostatic Hyperplasia (BPH)

Benign Prostatic Hyperplasia (BPH) is a common condition affecting aging men, characterized by the non-cancerous enlargement of the prostate gland. The condition results from hyperplasia of both stromal and epithelial cells of the prostate, leading to the formation of discrete nodules within the periurethral region.

Causes and Pathophysiology

• Hormonal Changes: Increased activity of dihydrotestosterone (DHT), a derivative of testosterone, plays a significant role in prostate enlargement.
• Cellular Hyperplasia: Growth factor dysregulation contributes to excessive proliferation of prostate cells.
• Inflammatory Processes: Chronic inflammation may trigger stromal proliferation, exacerbating symptoms.

Symptoms

Patients with BPH typically experience obstructive and irritative urinary symptoms, including:

• Frequent urination (especially at night, known as nocturia)
• Weak urine stream
• Incomplete bladder emptying
• Urgency and difficulty initiating urination

Prostate Cancer

Prostate cancer is a malignancy that arises from the prostate gland, often due to genetic and environmental factors. Unlike BPH, prostate cancer has the potential to invade surrounding tissues and metastasize.

Key Differences Between BPH and Prostate Cancer

Feature	BPH	Prostate Cancer
Nature	Non-cancerous hyperplasia	Malignant tumor growth
Progression	Slow, benign growth	May metastasize
Diagnosis	PSA testing, digital rectal exam	Biopsy, MRI, advanced imaging

Diagnosis and Treatment Options

Both conditions require different approaches for diagnosis and management:

• BPH: Medical therapy includes alpha-blockers and 5-alpha reductase inhibitors. Severe cases may require surgical intervention such as TURP (Transurethral Resection of the Prostate).
• Prostate Cancer: Treatment options depend on staging and severity, ranging from watchful waiting to surgery, radiation therapy, and chemotherapy.