Benign prostatic hyperplasia, or BPH, involves enlargement of the prostate gland. The prostate enlargement in benign prostatic hyperplasia is not malignant (not cancer). BPH can impede the flow of urine.

1. Benign Prostatic Hyperplasia (BPH)
Nodular Hyperplasia; Glandular & Stromal Hyperplasia
W. P. Rivindu H. Wickramanayake
Group no. 04a
3rd Year 2nd Semester – 2017 December
Tbilisi State Medical University, Georgia

3. Cause
Age related change (present in most men >60 years)
No increased risk of cancer

4. Pathogenesis
• Related to increased dihydrotestosterone (DHT)
DHT made from testosterone by 5alpha-reductase in stromal
cells
DHT acts on androgen receptors on stromal and epithelial
cells resulting in hyperplastic nodules
Trabecula  Hydronephrosis

5. Clinical features
Presentation based on pinching of urethra
 Decreased caliber and force of the stream
 Problems starting(hesitancy) and stopping urine stream; post-void dribbling
 Impaired bladder emptying - high risk of infection and hydronephrosis
 Urinary retention
 Incontinence
 Nocturia; polyuria / Dysuria
 Hypertrophy of bladder wall muscle - increased risk for bladder diverticula
 Microscopic hematuria maybe present

7. Complications
 Urinary tract infection
 Urinary bladder trabeculation and
 Diverticula formation
 Hydronephrosis and
 Renal failure (rare)
Cellulose
Trabeculae

8. Labs
 Slightly increased prostate
specific antigen (PSA) -
made by prostatic glands
and it liquefies semen (still
<10 ng/ml)

9. Grossly;
 An enlarged Prostate with well-demarcated
nodules in theTransition and Central
(periurethral) zones,
 which often results in slit-like compression of the
prostatic urethra.
Microscopically;
 Lesion shows Glandular and Stromal hyperplasia
resulting in the characteristic prostate enlargement.

10. corpora amylacea.

11. References ;
 Robbins Pathology – 10th Edition
 Pathoma Lecture Notes – 2017
 Board Review System – Pathology – 5th Edition
 https://library.med.utah.edu/WebPath/MALEHT
ML/MALEIDX.html