Benign Prostatic Hyperplasia
Reproductive · ~7% of blueprint- Pathophysiology
- Age-related prostate stromal/epithelial hyperplasia → bladder outlet obstruction.
- Signs & Symptoms
- Lower urinary tract symptoms — hesitancy, weak stream, nocturia, incomplete emptying; smooth enlarged prostate.
- Gold Standard Diagnosis
- Clinical + DRE (smooth, enlarged); AUA symptom score, urinalysis, PVR; PSA if cancer suspected or pre-5-ARI.
- First-line Treatment
- Alpha-blocker (tamsulosin) for bothersome LUTS; add a 5-alpha-reductase inhibitor (finasteride) if the prostate is enlarged (>30 cc, PSA >1.5, or palpable) to shrink it and prevent progression.
High-Yield Pearl
Alpha-blockers relax the prostate quickly; 5-ARIs shrink it over months (and lower PSA ~50%).
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Gross Anatomy
Physiology
Sources
Reviewed September 2026- Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline (2026) Part II: Medical Management — American Urological Association, 2026
- Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline Amendment 2023 — American Urological Association, 2023
- StatPearls: Benign Prostatic Hyperplasia — StatPearls Publishing / NCBI Bookshelf, 2026
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