IV.

PATHOPHYSIOLOGY (BPH)

Exact cause is Idiopathic

Estrogen

Men-50 y/o & above Diet Obesity DM Smoking

Ethnicity Hormonal fx Race Family Hx Alcohol use

Androgen

RISK FACTORS
Testosterone Become sensitive to growthstimulating hormone
5-alpha reductase

Dihydrosterone

Hyperplasia
Binds to nuclear androgen receptors

Signals prostate cell to replicate

Signals growth factors Late activation of cell growth

Apoptosis

Hyperplasia
Symmetrically enlarged gland

Narrows the lumen of the segment of the prostate

Encroaches upon the bladder neck reducing the ability to funnel in response to micturation

Growth of the socalled median lobe of the prostate extends into the proximal urethra

Prostate capsule influence hyperplasia to expand outward

Accompanied by hypertrophy of the smooth muscle gland (Benign Prostatic Hypertrophy)

Size of prostate

Muscular tone at the bladder neck & proximal urethra

Mechanically adds to the tse. constricting the urethral lumen

UTI Hematuria

OBSTRUCTION

Amplify the strength of the detrusor contraction

Urethral resistance

Overwhelms the detrusor muscles ability to ensure effective bladder evacuation by micturation

LUTS

Decline in the force of the urinary stream

Feelings of incomplete bladder emptying

Daytime voiding frequency

Urgency

Nocturia

Lower Urinary Tract Symptoms

Associated w/ overactive detrusor contractions

Urge urinary incontinence

Detrusor decompensate

Acute Urinary Retention

Urinary residual volumes

Weakened muscle contraction

Uremia

Peritonitis

Increase risk of postoperative complications