Benign Prostatic Hyperplasia: Understanding Pathophysiology and Etiology

Benign Prostatic Hyperplasia (BPH) is a common non-cancerous enlargement of the prostate gland, primarily affecting aging males. It leads to lower urinary tract symptoms (LUTS) due to the gradual growth of the prostate obstructing urinary flow.

Pathophysiology

BPH is characterized by hyperplasia of both epithelial and stromal cells within the transition zone of the prostate. Various factors contribute to this process:

• Hormonal Influence: Dihydrotestosterone (DHT) plays a crucial role in stimulating prostate cell growth.
• Cellular Proliferation: Alterations in apoptosis and cell proliferation cause excessive tissue buildup.
• Inflammatory Response: Chronic inflammation may contribute to abnormal cell growth.

Etiology

Several risk factors are associated with the development of BPH:

• Age: Commonly seen in men over 50.
• Hormonal Changes: Increased androgenic activity influences prostate tissue growth.
• Genetic Predisposition: Family history may increase risk.
• Lifestyle Factors: Obesity, diabetes, and diet can influence disease progression.

Clinical Manifestations

Patients with BPH may experience:

• Frequent urination
• Weak urine stream
• Incomplete bladder emptying
• Nocturia

Treatment Options

Treatment for BPH varies based on severity:

• Medications: Alpha-blockers and 5-alpha-reductase inhibitors help alleviate symptoms.
• Minimally Invasive Procedures: Techniques like UroLift and microwave therapy are available.
• Surgical Intervention: Transurethral resection of the prostate (TURP) remains the standard for severe cases.