Benign prostatic hyperplasia

The aetiological background of benign prostatic hyperplasia (BPH) is still obscure, though new information is steadily gained. In the context of pathomorphogenesis, major importance seems to be attributable to fibromuscular (stromal) tissue, since evidence has been produced to significant decline in glanduloparenchymal area relative to the normal overall volume of the prostate. Urine flow measurement has proved to be the most important screening test. Accurate presurgical determination of size of a hyperplastic prostate is not possible unless ultrasound is used. The hydrodynamic effects on the urinary bladder are recordable by means of combined flow and pressure measurement. Therapeutic medication is merely symptomatic, since no causative pharmacotherapy has so far become available. Transurethral prostatectomy is the optional approach to the majority of patients with prostatic symptoms. Postoperative complaints call for high-accuracy elucidation, since strictures and stones have frequently developed unnoticed.