Origin and evolution of benign prostatic enlargement

McNeal, J.E.

Investigative Urology 15(4): 340-345


ISSN/ISBN: 0021-0005
PMID: 75197
Document Number: 486
Important features of the origin and evolution of benign prostatic enlargement (BPH) remain unclarified, partly because of imprecision in previous morphologic observations. Precise, quantitative analysis was applied to BPH development in 63 human autopsy prostates. BPH nodules originated selectively from a very small region, near a cylindrical urethral sphincter above the verumontanum and usually on the outer aspect of that sphincter laterally. They arise in a newly described transition zone, in which the unique mingling of prostatic glands with sphincteric stroma may be implicated in BPH pathogenesis. Nodules originate through eccentric duct budding toward a focus, suggesting local stromal inductive effects. BPH evolved through 3 processes: early diffuse gland growth, small nodule proliferation and later nodule enlargement. If these are independent processes, BPH etiology may be multifactorial.

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Origin and evolution of benign prostatic enlargement