Prostatic Hyperplasia, Benign (BPH)
- Benign prostatic hyperplasia (BPH) is due to proliferation of both smooth muscle and epithelial cell lines of the prostate which causes increased prostate volume and may lead to compression of the urethra and obstructive symptoms.
- BPH presents clinically with storage and/or voiding symptoms known collectively as lower urinary tract symptoms (LUTS). These include difficulty initiating a urinary stream, frequency, urgency, nocturia, and/or dysuria.
- Symptoms do not directly correlate to prostate volume. It is estimated that only half of all men with histologic evidence of BPH experience moderate to severe LUTS.
- Progression may result in upper and lower urinary tract infections and may progress to direct bladder outlet obstruction and acute renal failure (ARF).
Age related with nearly universal development in men
Incidence increases with age with an estimated prevalence varying from 70% to 90% by the age of 80 years (estimated at 8–20% by age 40 years).
Etiology and Pathophysiology
- Unknown etiology
- Develops in prostatic periurethral or transition zone
- Hyperplastic nodules of stromal and epithelial components increase glandular components.
- Increasing age
- Higher free prostate-specific antigen (PSA) levels, heart disease, and use of β-blockers
- Low androgen levels from cirrhosis/chronic alcoholism reduces the risk of BPH
- Obesity and sedentary lifestyle can worsen LUTS
- No evidence of increased or decreased risk with smoking, alcohol, or any dietary factors
Symptoms can be managed through weight loss, regulation of fluid intake (especially in the evening), decreased intake of caffeine, and increased physical activity.
Commonly Associated Conditions
- LUTS can be divided into two groups:
- Filling/storage symptoms: frequency, nocturia, urgency, and urge incontinence
- Voiding symptoms: difficulty initiating urinary stream, incomplete voiding, or weak stream
- Sexual dysfunction, including erectile dysfunction and ejaculatory disorders
- LUTS can also be secondary to cardiovascular, respiratory, or renal disease (1).
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Domino, Frank J., et al., editors. "Prostatic Hyperplasia, Benign (BPH)." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816872/all/Prostatic_Hyperplasia__Benign__BPH_.
Prostatic Hyperplasia, Benign (BPH). In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816872/all/Prostatic_Hyperplasia__Benign__BPH_. Accessed May 29, 2023.
Prostatic Hyperplasia, Benign (BPH). (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816872/all/Prostatic_Hyperplasia__Benign__BPH_
Prostatic Hyperplasia, Benign (BPH) [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 May 29]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816872/all/Prostatic_Hyperplasia__Benign__BPH_.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Prostatic Hyperplasia, Benign (BPH) ID - 816872 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816872/all/Prostatic_Hyperplasia__Benign__BPH_ PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -