Benign prostatic hyperplasia BPH or benign prostatic enlargement BPE is an extremely common condition in elderly men and is a major cause of bladder outflow obstruction. Although the term prostatomegaly is often used interchangeably with BPH, strictly speaking prostatomegaly may refer to any cause of prostatic enlargement. As such it is often thought of essentially as a ingrandita volume prostatico cm part of aging 1.
Although a degree of prostatomegaly may be completely asymptomatic, the most common presentation is with lower urinary tract symptoms LUTS including :. An enlarged prostate may also be incidentally found on imaging of the pelvis or on digital rectal exam. Benign prostatic hyperplasia is due to a combination of stromal and glandular hyperplasia, predominantly of the transition zone as opposed to prostate cancer which typically originates in the peripheral zone.
Androgens DHT and testosterone are necessary for the development of BPH, but are not the direct cause for the hyperplasia. Chronic bladder outlet obstruction can lead to detrusor hypertrophy, trabeculation and formation of bladder diverticula.
Not typically used to assess the prostate, BPH is more frequently an incidental finding. Medical management for early disease typically commences with an alpha blocker such as tamsulosin given in combination with a 5-alpha reductase inhibitor such as dutasteride. Surgical management for symptomatic patients is typically with a transurethral resection of the prostate TURPand careful patient selection is important given the high prevalence of both BPH and lower urinary tract symptoms LUTS in this population.
Intermittent self catheterization is an option for those unsuitable for surgery. Urodynamic studies and prostate size estimation are often used to guide therapy, although prostate size in isolation is a poor predictor of symptom severity 4. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Updating… Please wait. Unable to process the form. Check for errors and try again. Thank you for updating your details. Log In. Sign Up. Log in Sign up.
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