Benign prostatic hyperplasia (BPH) is a benign adenomatous enlargement of the periurethral prostate gland. The gland overgrowth and cellular accumulation could originate from epithelial and stromal proliferation, apoptosis or both. BPH results due to the occurrence of the stromal and epithelial elements of the prostate in the periurithral and transition regions of the gland. Meanwhile, the hyperplasia most probably occurs due to the overgrowth of the prostate which might limit the urine flow from the bladder.
Clinical symptoms include bladder outlet obstruction such as weak stream, hesitancy, frequent urination, urgency, nocturia, partial emptying, excess/urge incontinence, terminal dribbling, and total urinary retention. BPH is diagnosed through digital rectal examination, cystoscopy, transrectal ultrasonography, urinalysis and culture, prostate-specific antigen level, and urodynamics. In men, BPH is regarded as a natural part of the aging course and is dependent hormonally on the production of testosterone and dihydrotestosterone (DHT). BPH arises only in males as females do not possess prostate glands; moreover it appears in 90% of men aged 85 years affecting the quality of their lives. Autopsy studies demonstrated that the prevalence of BPH increases from 8% in men aged 31 to 40 to 40-50% in men aged 51 to 60 years and to over 80% in men aged over 80 years. BPH is treated by 5alpha-reductase inhibitors (e.g., finasteride), alpha blockers (e.g., terazosin, alfuzosin, and tamsulosin) and corrective surgeries including transurethral resection of the prostate (TURP) and transurethral incision (TUI).
