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IV.

PATHOPHYSIOLOGY
(BPH)
Exact cause is Idiopathic
Men-50 y/o & above Ethnicity
Diet Hormonal fx
Obesity Race
DM Family Hx
Smoking Alcohol use
Estrogen

Androgen
RISK FACTORS
Testosterone
5-alpha
Become sensitive reductase
to growth- Dihydrosterone
stimulating
hormone Hyperplasia
Binds to nuclear
androgen
receptors
Signals prostate
cell to replicate
Signals growth
factors
Late activation of
cell growth

Apoptosis
Hyperplasia

Symmetrically
enlarged gland

Narrows the Encroaches upon Growth of the so- Prostate capsule influence Accompanied by hypertrophy of the smooth
lumen of the the bladder neck called median lobe hyperplasia to expand muscle gland (Benign Prostatic Hypertrophy)
segment of the reducing the ability of the prostate outward
prostate to funnel in extends into the
response to proximal urethra
micturation Muscular tone at Mechanically adds to
Size of prostate the bladder neck & the tse. constricting
proximal urethra the urethral lumen

UTI
Hematuria OBSTRUCTION

Overwhelms the detrusor muscles ability to


ensure effective bladder evacuation by
Amplify the strength of Urethral micturation
the detrusor contraction resistance

LUTS

Decline in the force of Feelings of Daytime voiding Urgency Nocturia


the urinary stream incomplete bladder frequency
emptying
Lower Urinary Tract
Symptoms

Associated w/ overactive
detrusor contractions

Urge urinary incontinence

Detrusor decompensate Acute Urinary Retention

Urinary residual volumes

Peritonitis
Uremia
Weakened muscle
contraction

Increase risk of post-


operative
complications

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