Benign Prostatic Hyperplasia

  • Catherine E. DuBeau


Benign prostatic hyperplasia (BPH) is the age-related proliferation of epithelial and stromal prostate tissue. Although this term often is used synonymously for prostate enlargement, bladder outlet obstruction, and associated voiding symptoms, these aspects of benign prostate disease are not equivalent. While histologic evidence of BPH is present nearly universally among elderly men, prostate enlargement results in only about half, and voiding symptoms occur in only about half of men with enlargement.1 Moreover, in elderly men “prostatism” voiding symptoms may in fact be due to age-related physiologic lower urinary tract changes, comorbid conditions, or medications—independent of any prostate disease.2,3 Indeed, similar “prostatism” symptoms occur in a significant proportion of older women.4 Even among symptomatic men with prostate enlargement, bladder outlet obstruction can be demonstrated urodynamically in only two thirds.5,6 Thus, the prostate is not inevitably the cause of voiding dysfunction in elderly men, regardless of the presence of prostate enlargement. Semantic clarity is essential for distinguishing the different aspects of benign prostate disease and understanding the relationships between them. In this chapter, the term BPH will be used only for a specific histologic finding, as distinct from benign prostate enlargement (BPE) and bladder outlet obstruction (BOO); the term prostatism will be replaced with voiding symptoms.7


Benign Prostatic Hyperplasia Transurethral Resection Bladder Outlet Obstruction Watchful Waiting Benign Prostatic Enlargement 
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© Springer Science+Business Media New York 1997

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  • Catherine E. DuBeau

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