Reflections on the Etiology of Benign Prostatic Hypertrophy

Abstract

So-called benign prostatic hypertrophy is a fibromuscular glandular hyperplasia of the prostate that occurs in the prostate of the human male as he ages. Although other aging animals such as the dog exhibit a diffuse hyperplasia of the prostate, the characteristic nodular hypertrophy of man is unique. Histological studies indicate that benign prostatic hypertrophy usually begins in the inner or suburethral prostatic glands. Either stromal or epithelial changes may initiate or predominate in this process(^1,2). Although atrophic changes in the peripheral prostatic glands may accompany the proliferation of the periurethral elements, weight(³) and volume(⁴) studies indicate that the overall size of the prostate of man increases with aging. Histological evidence of benign prostatic hypertrophy is present in most, not all, men over 60 years of age(⁵).

Biased written speculation is usually avoided by most of us, scientists, pseudoscientists, or what have you, since the risk of error and ridicule outweigh the potential personal rewards and public good. However, the man we are honoring by this effort, Professor W. W. Scott, has characterized his relationship with us by an attitude of tolerance toward our indiscretions and encouragement for our sincere individual efforts without placing a value judgment on them. His attitude and the security of our friendships encourage me to present a brief, selective summary of observations concerning benign prostatic hypertrophy and prostatic growth in man and animals and to attempt to relate them to each other.