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Benign prostatic hyperplasia (BPH) also known as benign prostatic hypertrophy, benign enlargement of the prostate (BEP)and adenofibromyomatous hyperplasia, refers to the increase in size of the prostate inmiddle-aged and elderly men.

It leads to symptoms of urinary hesitancy, frequent urination,dysuria (painful urination), increased risk of urinary tract infections, and urinaryretention. Although prostate specific antigen levels may beelevated in these patients because of increased organ volume and inflammationdue to urinary tract infections, BPH is not considered to be a pre malignant lesion.

Signs and symptoms

Benign prostatic hyperplasia symptoms are classified as storage or voiding.

Storage symptoms include urinary frequency, urgency (compelling need tovoid that cannot be deferred), urgency incontinence, and voiding at night (nocturia).

Voiding symptoms include weak urinary stream, hesitancy (needing to waitfor the stream to begin), intermittency (when the stream starts and stopsintermittently), straining to void, and dribbling. Pain and dysuria (burningsensation in the urethra) are usually not present. These storage and voidingsymptoms are evaluated using the International Prostate SymptomScore (IPSS) questionnaire, designed to assess the severity of BPH.

BPH can be a progressive disease, especially if left untreated. Incomplete voidingresults in stasisof bacteriain the bladder residue and an increased risk of urinary tract infection. Urinary bladderstones are formed from the crystallizationof salts in theresidual urine. Urinary retention, termed acuteor chronic, is another form of progression. Acuteurinary retention is the inability to void, while in chronic urinary retentionthe residual urinary volume gradually increases, and the bladder distends. Somepatients that suffer from chronic urinary retention may eventually progress torenal failure, a condition termed obstructive uropathy.


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