BENIGN PROSTATIC HYPERPLASIA (BPH) Flashcards
BENIGN PROSTATIC HYPERPLASIA (BPH) is an extremely common cause of
prostatic enlargemen
Benign prostatic hyperplasia It is present in
significant number of men by 40 years of age
Bph frequency
90% by the eighth decade of life
The enlargement of the prostate in men with BPH is an important cause of
urinary obstruction
Bph results from
from proliferation of stromal and glandular elements
Pathogenesis of bph
excessive androgen-dependent growth of stromal and glandular elements
BPH does not occur in males who
are castrated before the onset of puberty or
in males with genetic diseases that block androgen activity
ultimate mediator of prostatic growth
Dihydrotestosterone (DHT)
How is Dihydrotestosterone (DHT) synthesised and where
the prostate from circulating testosterone by the action of the enzyme 5α-reductase, type 2.
DHT binds to …. which….
nuclear androgen receptors
, which regulate the expression of genes that support the growth and survival of prostatic epithelium and stromal cells.
Although … can also bind to androgen receptors and stimulate growth, DHT is … times more potent.
testosterone
10
BPH virtually always occurs in
the inner transition zone of the prostate.
Bph affected prostate is
Enlarged
• 60 and 100 g,
Gross morphology
many well circumscribed nodules that
bulge from the cut surface
solid or contain cystic spaces
• the urethra is usually compressed →narrow slit
LM
the hyperplastic nodules → variable proportions of
proliferating glandular elements and fibromuscular stroma
The hyperplastic glands are lined by
tall, columnar epithelial cells and
a peripheral layer of flattened basal c
Lm The glandular lumina often contain
laminated proteinaceous secretory material = corpora amylacea
What is corpora amylacea
laminated proteinaceous secretory material
Pic
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Clinical Features of bph
involves the inner portions of the prostate → lower urinary tract obstruction • difficulty in starting the stream of urine =hesitancy and
intermittent interruption of the urinary stream while voiding
• These symptoms frequently are accompanied by →
urinary urgency,
frequency, and
nocturia, all indicative of bladder irritation
The presence of residual urine in the bladder due to chronic obstruction increases the risk for
urinary tract infection
If BPH leads to complete urinary obstruction
→painful distention of the bladder and, in the absence of appropriate treatment, hydronephrosis.
