ReasonDx: Benign Prostatic Hyperplasia (BPH)

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About ReasonDx: Benign Prostatic Hyperplasia (BPH)

Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland that commonly affects men over 50 years of age. The enlarged prostate compresses the urethra, leading to characteristic lower urinary tract symptoms including urinary frequency, urgency, weak stream, and incomplete bladder emptying.

Pathophysiology

BPH results from hormonal changes associated with aging, particularly increased dihydrotestosterone (DHT) levels and altered estrogen-to-testosterone ratios that stimulate prostate cell proliferation. The enlarged prostate tissue creates both static obstruction by physically compressing the urethra and dynamic obstruction through increased smooth muscle tone in the prostate and bladder neck.

Clinical Reasoning

Diagnosis relies on symptom assessment using validated questionnaires like the International Prostate Symptom Score (IPSS), digital rectal examination revealing an enlarged prostate, and objective measures such as uroflowmetry and post-void residual volume. Treatment ranges from watchful waiting for mild symptoms to alpha-blockers and 5-alpha reductase inhibitors for moderate symptoms, with surgical intervention reserved for severe cases or complications like urinary retention.

References

  1. Benign Prostatic Hyperplasia - StatPearls. StatPearls / NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK558920/

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