Slide 1

Definition
BPH is a slowly progressive nodular hyperplasia of the periurethral (transition) zone of the
prostate.
Epidemiology
-BPH is the most common neoplasm in man
-The aetiology of BPH is multifactorial: the presence of testes and aging is most important.
-Pathology is found in 50% of men in their 5th decade and in 90% of men in their ninth decade.

Slide 2
Symptoms and Signs
 The symptoms are: obstructive (and/or) irritative S/S
 Obstructive S/S: due to prostatic enlargement
 Hesitancy =delayed initiation of the act.
 Weak stream of urine=decrease in the force&caliber of the urinary stream
 Abdominal straining
 Intermittency
 Sense of incomplete evacuation
 Terminal micturition dribbling
 Post voiding dribbling

Slide 3
Pathophysiology
 Stages: BPH is a progressive disease
 Mild infravesical obstruction leads ti minimal S/S
 Increase of infravesical obstruction with bladder compensation by detrusor hypertrophy
leads to LUT obstructive symptomsb
 Severe infravesical obstruction with bladder instability and decrease compliance leads to
Irritative S/S

 The obstructive component can be subdivided into:

A-Mechanical: due to transition zone enlargement.
B-Dynamic: due to adrenergic stimulation of stromal smooth muscle
Slide 4
Symptoms and signs
 Irritative S/S: due to the secondary response of the bladder to the outlet resistance.

 Dysuria
 Increased frequency
 Nocturia
 Urgency and urge incontinence
3-Retention:
a-Acute retention means sudden inability to micturate +/-agonizing supra public pain.
b-Chronic retention refers to increase in the post voiding volume which may present with
retention with over flow, nocturnal enuresis or stress incontinence
4-Haematuria
5-Uraemic symptoms