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BENIGN PROSTATIC HYPERPLASIA - Coggle Diagram
BENIGN PROSTATIC HYPERPLASIA
Definition
Non-malignant enlargement of the prostate due to stromal + glandular hyperplasia, arising mainly in the transitional zone.
Pathophysiology
Stem cell proliferation and increased lifespan
Genetic susceptibility (growth factor & AR-related genes)
Estrogen/androgen imbalance with aging
Results in nodular hyperplasia → urethral compression → bladder outlet obstruction
Androgens (DHT) stimulate prostatic cell growth
Clinical Presentation
Irritative: frequency, urgency, nocturia
Acute/chronic urinary retention in severe cases
Obstructive: hesitancy, weak stream, straining, incomplete emptying
Examination Findings
Digital rectal exam (DRE): enlarged, smooth, firm, rubbery prostate (symmetrical)
No hard nodules (distinguishes from carcinoma)
Treatment
Medical
α-blockers (tamsulosin) → relax smooth muscle
5-α reductase inhibitors (finasteride) → shrink prostate
Surgical: TURP (transurethral resection), laser ablation, prostatectomy for severe/complicated cases
Lifestyle: reduce evening fluids, caffeine, alcohol
Investigations
PSA (to exclude prostate cancer overlap)
Ultrasound (prostate size, post-void residual)
Serum creatinine (renal function)
Uroflowmetry (flow rate, obstruction assessment)
Urinalysis (exclude infection/hematuria)
Prevention
No definitive prevention
Early detection and management to prevent complications
Risk Factors
Intact androgen production
Family history/genetics
Increasing age
Metabolic syndrome, obesity