Pathophysiology of Benign Prostatic Hyperplasia (BPH)

What happens? unregulated hyperplastic growth of the epithelial and fibromuscular tissues of the transition zone (TZ) and periurethral area. This blocks the flow of urine.  

Genetics/ Hereditary

• loss of Y chromosome
• single-nucleotide polymorphisms (SNPs)

Androgen 

• testosterone derived play role in prostate health 
• Androgen receptor expression may be upregulated 
• incidence increases with age, when testosterone also decreases 

Oestrogens 

• men with metabolic dysfunction 
  • larger adipose tissue can lead to increased conversion of androgens to oestrogens 
  • along with the decrease in testosterone, the altered balance may account for the hyperplasia

Insulin 

• increased incidence of BPH in diabetes pts
• the receptor for an insulin mediator is found in higher levels 

Growth Factors

• changes in sex hormone balance maintain hyperplastic processes 
• linked with inflammation? 

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