Benign Prostatic Hyperplasia: Epidemiology, Pathophysiology, and Clinical Manifestations

Abstract

The prostate secretes 20% of the seminal fluid. One of its main pathologies is benign prostatic hyperplasia (BPH), the most common benign disease in older men. It has an 8–10% prevalence in men 40 years of age and older, increasing to more than 90% in men over 90 years, with lower urinary tract symptoms being one of its main complications. Although the etiology of BPH is not still fully known, testosterone and estradiol have shown a permissive role. Likewise, other factors have emerged, such as inflammation, growth factors, and prolactin, which influence the development of BPH. These factors act through binding to specific receptors, intervening in BPH and prostate cancer development. Existing treatments significantly reduce clinical symptoms, including lower urinary tract symptoms. However, it is a nonpreventable disease; some factors can reduce its incidence: diet, physical activity, and moderate consumption of alcohol and tobacco, some of which have been proposed to have a protective role. Therefore, this chapter aims to update the preclinical and clinical evidence on the etiology of this disease, briefly describing the epidemiology, clinical manifestations, and therapeutic and preventive modalities in managing BPH.