The Definition of Benign Prostatic Hyperplasia

BPH is a progressive disease characterized by prostate stromal and epithelial cell hyperplasia, which usually begins in the periurethral zone of the prostate. This process can be asymptomatic or associated with lower urinary tract symptoms (LUTS), typified by urinary frequency and urgency, nocturia, decreased and/or intermittent force of stream, and incomplete bladder emptying.9 BPH is extremely common; one European survey of 80 774 subjects estimated that the prevalence of symptomatic BPH was 2.7% in men aged 45-49 years and 24% in men aged 80 years and over. Similar age-related trends have been observed in the USA, with an incidence of 34/100000 in 20- to 39-year-olds compared with a peak incidence of 1803/100 000 in 60- to 69-year-olds10 (see Table 1). Histopathologic evidence of BPH places the burden much higher, with a prevalence around 50% in men aged 60 years and 85% in men aged

90 years and over.9,11

Micronodular growth

Nodular growth

Clinical BPH (obstruction to urinary flow)

Micronodular growth

Nodular growth

Clinical BPH (obstruction to urinary flow)

DHT estrogens

30 years

Imbalance of growth regulatory factors

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