Benign Prostatic Hyperplasia (BPH) - Rivin

Benign prostatic hyperplasia, or BPH, involves enlargement of the prostate gland. The prostate enlargement in benign prostatic hyperplasia is not malignant (not cancer). BPH can impede the flow of urine.

1. Be ni gn Prostatic Hyperplasia (BPH) No dular Hyperplasia; Glandular & Stromal Hyperplasia W. P. Rivindu H. Wickramanayake Group no. 04a 3rd Year 2nd Semester – 2017 December Tbilisi State Medical University, Georgia

2. Cause Age related change (present in most men >60 years) No increased risk of cancer

3. Pathogenesis • Related to increased dihydrotestosterone (DHT) DHT made from testosterone by 5alpha-reductase in stromal cells DHT acts on androgen receptors on stromal and epithelial cells resulting in hyperplastic nodules Trabecu la  Hydro nephrosis

4. Clinical features Presentation based on pinching of urethra Decreased caliber and force of the stream Problems starting(hesitancy) and stopping urine stream; post-void dribbling Impaired bladder emptying - high risk of infection and hydronephrosis Urinary retention Incontinence Nocturia ; polyuria / Dysuria Hypertrophy of bladder wall muscle - increased risk for bladder diverticula Microscopic hematuria maybe present

5. Complications Urinary tract infection Urinary bladder trabecu la tion and Diverticula formation Hydronephrosis and Renal failure (rare) Cellulose Trabeculae

6. Labs Slightly increased prostate specific antigen (PSA) - made by prostatic glands and it liquefies semen (still <10 ng /ml)

7. Grossly; An enlarged Prostate with well-demarcated nodules in the Transition and Central ( periurethral ) zones , which often results in slit-like compression of the prostatic urethra. Microscopically; Lesion shows Glandular and Stromal hyperplasia resulting in the characteristic prostate enlargement.

8. corpora amylacea .

9. References ; Robbins Pathology – 10th Edition Pathoma Lecture Notes – 2017 Board Review System – Pathology – 5th Edition https://library.med.utah.edu/WebPath/MALEHTML/MALEIDX.html

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