Editing Benign prostatic hypertrophy (section)

== Pathophysiology ==

* Proposed to occur secondary to increasing oestrogenic stimulus over time
* Affects both glandular epithelium and connective tissue
* Typically affects submucosal glands in transitional zone, forming a nodular enlargement
* Complex relationship between BPH, BOO and LUTS
**
* '''Bladder outlet obstruction:'''
** Urodynamic concept - low flow rates in the presence of high voiding pressures
** Can result from:
*** BPH
*** Bladder neck stenosis
*** Bladder neck hypertrophy
*** Prostate cancer
*** Urethral strictures
*** Functional obstruction due to neuropathic conditions
** Consequences:
*** Decompensated bladder - less efficient detrusor contraction, residual urine
*** Irritable bladder with decrease in functional capacity
*** Acute/chronic urinary retention
*** Impaired bladder emptying
*** Haematuria (complication of BPH or otherwise)
*** Pain is not a symptom of BOO, other than AUR
* Anatomical effects of BPH:
** Urethra - lengthened prostatic urethra, but not narrowed
** Bladder - if BPH causes BOO, the musculature of the bladder hypertrophies to overcome the obstruction and appears trabeculated. Significant BPH is a/w increased blood flow, and the resultant veins at the base of the bladder are apt to cause haematuria.