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Benign Prostate Hyperplasia: Causes and consequences.

Updated: Jul 2, 2023

Benign prostatic hyperplasia (BPH) is a condition that involves the enlargement of the prostate gland, which can lead to urinary problems such as difficulty in starting urination, weak urine flow, and frequent urination. The pathophysiology of BPH involves several complex mechanisms, which are detailed below:

  1. Hormonal changes: The prostate gland is regulated by androgens, which are male sex hormones such as testosterone and dihydrotestosterone (DHT). As men age, the levels of testosterone decrease while the levels of DHT increase, which leads to an enlargement of the prostate gland.

  2. Inflammation: Chronic inflammation in the prostate gland may contribute to the development of BPH. Inflammation can cause the prostate gland to produce growth factors, which stimulate the growth of prostate cells.

  3. Smooth muscle hypertrophy: BPH can also involve the growth and enlargement of smooth muscle cells in the prostate gland. This can cause an increase in the tone of the prostate gland, which can lead to urinary obstruction.

  4. Increased tissue stiffness: The prostate gland becomes stiffer as it enlarges, which can contribute to the compression of the urethra and urinary obstruction.

  5. Obstruction of the urethra: The enlarged prostate gland can obstruct the flow of urine through the urethra, leading to urinary symptoms such as difficulty starting urination, weak urine flow, and frequent urination.

  6. Bladder dysfunction: Over time, the obstruction of the urethra can cause the bladder to become overactive and hypertrophied, which can lead to urinary retention, urinary tract infections, and other complications.

Patient undergoing an ultrasound scan to assess the volume of the prostate gland.
Urologist assessing the patient

In summary, BPH is a complex condition that involves several mechanisms including hormonal changes, inflammation, smooth muscle hypertrophy, increased tissue stiffness, urethral obstruction, and bladder dysfunction. These mechanisms can lead to the urinary symptoms associated with BPH and can cause complications if left untreated.

If you demonstrate symptoms of bladder outflow obstruction, then the best course would be to visit a urologist for a full assessment.

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