Scribd Logo
Upload

Welcome to Scribd!

  • 29 views

    Pathophysiology of BPH

    Uploaded by

    Junaida Afifa
    BPH is caused by an imbalance between cell proliferation and cell death in the prostate, leading to increased cell numbers and enlarged prostate size. While androgens stimulate prostate cell growth, they also inhibit cell death, contributing to enlargement. BPH specifically develops in the prostate transition zone as a hyperplastic process. The varying composition of stroma and epithelium in BPH nodules explains differences in how BPH responds to medical therapies by decreasing autonomic tone. Obstructive urinary symptoms result from increased outlet resistance caused by the enlarged prostate, while irritative symptoms occur as the bladder undergoes changes in response to obstruction, including muscle and collagen changes. Long-term complications can develop if BPH is left untreated, including

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Pathophysiology of BPH

    Uploaded by

    Junaida Afifa
    29 views2 pages
    BPH is caused by an imbalance between cell proliferation and cell death in the prostate, leading to increased cell numbers and enlarged prostate size. While androgens stimulate prostate cell growth, they also inhibit cell death, contributing to enlargement. BPH specifically develops in the prostate transition zone as a hyperplastic process. The varying composition of stroma and epithelium in BPH nodules explains differences in how BPH responds to medical therapies by decreasing autonomic tone. Obstructive urinary symptoms result from increased outlet resistance caused by the enlarged prostate, while irritative symptoms occur as the bladder undergoes changes in response to obstruction, including muscle and collagen changes. Long-term complications can develop if BPH is left untreated, including

    Original Description:

    bph

    Original Title

    bph

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    BPH is caused by an imbalance between cell proliferation and cell death in the prostate, leading to increased cell numbers and enlarged prostate size. While androgens stimulate prostate cell growth, they also inhibit cell death, contributing to enlargement. BPH specifically develops in the prostate transition zone as a hyperplastic process. The varying composition of stroma and epithelium in BPH nodules explains differences in how BPH responds to medical therapies by decreasing autonomic tone. Obstructive urinary symptoms result from increased outlet resistance caused by the enlarged prostate, while irritative symptoms occur as the bladder undergoes changes in response to obstruction, including muscle and collagen changes. Long-term complications can develop if BPH is left untreated, including

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    29 views2 pages

    Pathophysiology of BPH

    Uploaded by

    Junaida Afifa
    BPH is caused by an imbalance between cell proliferation and cell death in the prostate, leading to increased cell numbers and enlarged prostate size. While androgens stimulate prostate cell growth, they also inhibit cell death, contributing to enlargement. BPH specifically develops in the prostate transition zone as a hyperplastic process. The varying composition of stroma and epithelium in BPH nodules explains differences in how BPH responds to medical therapies by decreasing autonomic tone. Obstructive urinary symptoms result from increased outlet resistance caused by the enlarged prostate, while irritative symptoms occur as the bladder undergoes changes in response to obstruction, including muscle and collagen changes. Long-term complications can develop if BPH is left untreated, including

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Pathophysiology of BPH1,2

    In a given organ, the number of cells, and thus the volume of the organ, is
    dependent on the equilibrium between cell proliferation and cell death (Isaacs and
    Coffey, 1987). An organ can enlarge not only by an increase in cell proliferation but
    also by a decrease in cell death. Although androgens and growth factors stimulate cell
    proliferation in experimental models, the relative role of cell proliferation in human
    BPH is questioned because there is no clear evidence of an active proliferative
    process. Androgens not only are required for normal cell proliferation and
    differentiation in the prostate but also actively inhibit cell death. The development of
    BPH requires the present of testicular androgens during prostate development,
    puberty, and aging although androgens don’t cause BPH.
    BPH develops in the transition zone. It is truly a hyperplastic process resulting
    from an increase in cell number. Microscopic evaluation reveals a nodular growth
    pattern that is composed of varying amounts of stroma and epithelium. Stroma is
    composed of varying amounts of collagen and smooth muscle. The differential
    representation of the histologic components of BPH explains, in part, the potential
    responsiveness to medical therapy. The prostatic stroma, composed of smooth muscle
    and collagen, is rich in adrenergic nerve supply. The level of autonomic stimulation
    thus sets a tone to the prostatic urethra. Use of alpha-blocker therapy decreases this
    tone, resulting in a decrease in outlet resistance.

    Picture 1. Pathophysiology of BPH


    The irritative voiding
    complaints of BPH result from the
    secondary response of the bladder
    to the increased outlet resistance.
    Bladder outlet obstruction leads to
    detrusor muscle hypertrophy and
    hyperplasia as well as collagen
    deposition. Although the latter is
    most likely responsible for a
    decrease in bladder compliance,
    detrusor instability is also a factor.
    Clinical Manifestations2
    The symptoms of BPH can be divided into obstructive and irritative
    complaints. Obstructive symptoms include hesitancy, decreased force and caliber of
    stream, sensation of incomplete bladder emptying, double voiding (urinating a second
    time within 2 hours of the previous void), straining to urinate, and post-void
    dribbling. Irritative symptoms include urgency, frequency, and nocturia.

    Complications3
    If the conditions still continue, urine residue will remain in the bladder. In the
    end, patient can’t urinate anymore because total obstruction is occurred (urine
    retention). Pressure in the bladder will increase. And then, when the pressure in the
    bladder is higher, overflow incontinence is occurred. Urine will be reflux to the
    ureter, and then hydroureter, hydronephrosis, dan renal failure will be occurred.

    1. Campbell
    2. Smith
    3. Gaol HL, Mochtar CA. Kapita Selekta Kedokteran Jilid I. Edisi 4. Jakarta :
    Media Aesculapius; 2014.

    You might also like