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Benign Prostate Hypertrophy:
Benign prostate hypertrophy also known as benign enlargement of prostate is a condition seen in middle aged men and elder men in which there is increase in the size of prostate. There is hyperplasia of prostatic stromal cells and epithelial cells leading to formation of large nodules in the peri-urethral area of the prostate. Hence if these nodules are large enough then they can suppress the urethral canal completely or partially leading to obstruction in urine flow leading to - urinary hesitancy, - frequent urination - increased risk of urinary tract infections due to stasis of bacteria in the bladder residue - incomplete voiding - Post-urination dribble - Nocturia– need to urinate during the night - Intermittency - Dysuria: painful urination - weak urinary stream, - straining - Urinary retention which may be acute [inability to void] or chronic in which there is gradual increase in the residual urinary volume, distending the bladder. This may lead to renal failure termed as obstructive uropathy. - Urinary bladder stone formation.
Dihydrotestosterone, a metabolite of testosterone plays a critical role in the growth of prostate. Dihydrotestosterone is synthesized under the action of the enzyme 5?-reductase, type 2 in the prostate from the circulating testosterone. Since this enzyme is localized primarily in the stromal cells; hence, these cells are the main site for the synthesis of dihydrotestosterone. Although all men show prostate hypertrophy as they age, especially after 70 years, the incidence of symptomatic prostatic hypertrophy is observed more in men have a western lifestyle than in men from rural areas. Benign hypertrophy of prostate is associated with increased levels of serum ‘prostate specific antigen [PSA]’ which is a marker for carcinoma prostate, it is not considered to be a pre-malignant condition. This condition is diagnosed mainly by rectal examination and by ultrasonography.