The prostate is the genital organ most commonly affected by benign a n d m a l i g n a n t neoplasm.

Benign enlargement of the prostate gland is an extremely common process that occurs in nearly all men with functioning testes. Hyperplasia is a general medical term referring to excess cell replication. Benign prostatic hyperplasia (BPH) is a non cancerous growth of the prostate gland. It is the most common non cancerous form of cell growth in men and usually b e g i n s w i t h m i c r o s c o p i c n o d u l e s i n y o u n g e r m e n . I t s h o u l d b e n o t e d t h a t B P H i s n o t a precancerous condition. Some studies have suggested that African American men are at higher risk and Asian m e n at lower risk for BPH than Caucasians, a 2000 study found no g r e a t e r r i s k f o r A f r i c a n Americans and only a slightly lower risk for Asians. Among Caucasians in the study, men of southern European heritage were at greater risk while men of Scandinavian ancestry had a lower chance of developing BPH. Histologic evidence of prostate enlargement begins about the third decade of life and increases proportionally with aging. Specifically, about 43% of men in their 40s will have evidence of BPH, as will 50% of men in their 50s, 75% to 88% in their 80s, and nearly 100% of men reaching the ninth decade of life. Some evidence has reported a higher incidence of benign prostatic h y p e r p l a s i a - - particularly fast-growing BPH -- in men with obesity, heart and circulatory diseases, and type 2diabetes. Diabetes and hypertension, in any case, worsens urinary tract symptoms in men with B P H . I n o n e s t u d y , f l o w rates were adversely affected by diabetes, although residual urine volumes were not significantly greater. The exact cause of BPH is unknown. Potential risk factors include age, family history, race, ethnicity, and hormonal factors. Androgens (male hormones) most likely play a role in prostate growth. The most important androgen is testosterone which is produced throughout
am a n ' s l i f e t i m e . T h e p r o s t a t e c o n v e r t s t e s t o s t e r o n e t o a more powerful androgen,

dihydrotestosterone. DHT stimulates cell growth in the tissue that lines the prostate gland(the glandular epithelium) and is the major cause of the rapid prostate enlargement that occurs between puberty and young adulthood. DHT is a prime suspect in prostate enlargement in later adulthood. Additional factors also include a defective cell death in which cells naturally self-destruct, goes awry and results in cell proliferation a process called as apoptosis .A s B P H p r o g r e s s e s , o v e r g r o w t h o c c u r s i n t h e c e n t r a l a r e a o f t h e prostate called the transition zone, which wraps around the urethra (the tubethat carries urine through the penis). This pressure on the urethra can causel o w e r u r i n a r y s y m p t o m s t h a t h a v e b e e n t h e b a s i s f o r
diagnosing BPH. Itshould be noted that BPH is not always the cause of these symptoms. Anenlarged prostate may be accompanied by few symptoms, while s evereLUTS may be present with normal or even small prostates and a r e m o s t likely due to other conditions. Symptoms of BPH may include;

Difficulty instarting to pass urine (hesitancy), a weak stream of urine, dribbling after urinating, the need tostrain to pass urine, incomplete emptying of bladder, difficulty to control the urination urge,h a v i n g t o g e t u p s e v e r a l

times in the night to pass urine, feeling a burning sensation w h e n passing urine.Sometimes a man is unaware of an obstruction until he suddenly cannot urinate at all.This condition is called acute urinary retention. It is a dangerous complication that can damagethe kidneys and may require emergency surgery. In general, BPH progresses very slowly andacute urinary retention is very uncommon. Men with BPH at highest risk for this complicationt e n d t o b e e l d e r l y a n d t o h a v e m o d e r a t e t o s e v e r e l o w e r v o i d i n g s y m p t o m s . T a k i n g a n t i - hypertensive drugs (except for diuretics) or antiarrhythmic drugs may also increase the risk.Bladder obstruction can also cause bladder stones, blood in the urine, urinary tract infection, andincontinence. Unfortunately, no current tests can accurately predict which men are at higher risk for complications, although men with a weak urine stream and larger prostates are at higher risk for urinary retention.Diagnostic tests used to confirm Benign Prostatic Hyperplasia include Digital RectalExam, Urinalysis, Serum Creatinine, Postvoid Residual Urine, Ultrasound, Urethrocystoscop

the prostate gland is located under the urinary bladder, in front of the rectum and wrapsaround the urethra (the tube that carries urine through the penis) It is basically composed of three different cell types the glandular cells, smooth muscle cells and stromal cellsThe central area of the prostate that wraps around the urethra is called the transition zone.The entire prostate gland is surrounded by a dense, fibrous capsule.The prostate gland provides the following functions: (1) the glandular cells produce amilky fluid, and during sex the smooth muscles contract and squeeze this fluid into the urethra.Here, it mixes with sperm and other fluids to make semen. (2) the prostate also secretes another substance that may have antibacterial properties. (3) the prostate gland also contains an enzymecalled 5 alpha-reductase that converts testosterone to dihydrotestosterone, another male hormonethat has a major impact on the prostate.The prostate gland undergoes many changes during the course of a man's life. At birth,the prostate is about the size of a pea. It grows only slightly until puberty, when it begins to e n l a r g e r a p i d l y , a t t a i n i n g normal adult size and shape, about that of a walnut, when a m a n reaches his early 20s.The gland generally remains stable until about themidforties,when,Inm o s t m e n , t h e p r o s t a t e b e g i n s t o e n l a r g e a g a i n t h rough a process of cell multiplication.H o r m o n a l c h a n g e s a l s o o ccur in the prostate gland; testosterone levels fall whil e dihydrotestosterone remain at normal levels.