[vc_row][vc_column][vc_column_text]Also known as benign prostatic hypertrophy or enlarged prostate, benign prostatic hyperplasia (BPH) is a disease that affects men. The prostate is a gland the size and shape of a walnut, located near the bladder and rectum, surrounding the urethra, which plays an important role in men’s reproductive system. Due to the disease, the prostate gland becomes swollen and may compress or block the urethra, causing urinary problems. Pathophysiology focuses on the features that compose the disease or the functional alterations associated with it, which is important to understand its development and treatment.

“Nearly all men will develop histological benign prostatic hyperplasia by the age of 80, but the degree of prostatic enlargement resulting from the hyperplasia is highly variable. Historically, it has often been assumed that the pathophysiology of lower urinary tract symptoms (LUTS) in men is the result of bladder outlet obstruction associated with prostatic enlargement. The observation that prostatic enlargement, bladder outlet obstruction, and LUTS are all age-dependent has been interpreted to indicate that these phenomena were causally related, but there is insufficient evidence for this,” state the authors of the study “Pathophysiology of Benign Prostatic Hyperplasia in the Aging Male Population.”

Benign Prostatic Hyperplasia and Hormonal Pathophysiology

Despite the fact that the reasons for the development of benign prostatic hyperplasia are not fully understood, the impact of hormones on the disease is well documented. While men produce large amounts male hormones called testosterone throughout their lives and small amounts of female hormones, estrogen, as they get old, the production of testosterone decreases, creating an impairment and resulting in BPH. This explains why the only group of men that does not develop benign prostatic hyperplasia are those who have had the testicles removed as children due to cancer or any other disease. When the testicles are removed later in life, the size of the prostate may decrease.

Simultaneously, the potent androgen dihydrostestosterone (DHT) accumulates in the prostate due to a process during which type II 5-alpha-reductase metabolizes, circulating testosterone into DHT. DHT and androgen receptors connect to each other in the cell nuclei and end up resulting in benign prostatic hyperplasia. Due to the recognition of this fact, researchers have focused on the blockage of alpha-1-adrenergic receptors in the smooth muscle of the stroma and capsule of the prostate and in the bladder neck, which has been proven effective in relaxing the muscles and relief the symptoms of the disease.

Benign Prostatic Hyperplasia and Microscopic Pathophysiology

The microscopic pathophysiology of benign prostatic hyperplasia demonstrated the hyperplastic process that occurs in the gland. The hyperplasia is a result of the swollen prostate, which blocks the normal flow of urine from the bladder through the urethra to be expelled. The prostate enlargement is faced as a normal part of male aging, while the most typical explanation for the disease focus on the fact that the swollen gland cannot radially expand due to the surrounding capsule, but it can compress the urethra. But researchers also note the importance of obstruction-induced bladder dysfunction in the development of symptoms.

In addition, analyzing microscopically the features of benign prostatic hyperplasia reveal that there is an increased sensitivity known as detrusor overactivity in the bladder that contribute for both urinary frequency and BPH symptoms, even if there is little urine in the bladder. Throughout time, the walls of the bladder become weaker and the organ may lose the ability to fully empty during urination. Bladder obstruction also results in smooth-muscle-cell hypertrophy.[/vc_column_text][vc_row_inner][vc_column_inner width=”1/2″][vc_wp_rss items=”7″ title=”Read The Latest News About Benign Prostatic Hyperplasia” url=”https://bphnews.com/tag/bph/feed”][/vc_column_inner][vc_column_inner width=”1/2″][vc_wp_text title=”Find Out More”]
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