BPH/TURP

Benign prostatic hyperplasia is a nonmalignant increase in stromal and epithelial cells, usually in the transition zone surrounding the urethra. Enlargement narrows the bladder outlet, but obstruction is not purely a matter of prostate size. The enlarged tissue creates a fixed, or static, narrowing; alpha-adrenergic smooth-muscle tone adds a variable, or dynamic, narrowing. The bladder initially compensates by generating stronger detrusor contractions. Over time, the detrusor may become thickened, irritable, and less compliant. This produces storage symptoms such as frequency, urgency, and nocturia. If obstruction persists, bladder emptying becomes incomplete, leaving a residual volume that can progress to infection, stones, retention, or eventual detrusor decompensation. The symptom pattern is more useful than the word “enlargement” alone: - Voiding symptoms: hesitancy, weak or intermittent stream, straining, prolonged voiding, and terminal dribbling. - Storage symptoms: urgency, increased frequency, nocturia, and sometimes urge incontinence. - Post-micturition symptoms: a sensation of incomplete emptying or post-void dribbling. BPH is benign histologically, but LUTS are not specific to BPH. Prostatitis or urinary infection, bladder stones, malignancy, medication effects, neurogenic bladder, and urethral stricture can produce similar...