Etiology and Pathogenesis

Benign prostatic hyperplasia (BPH) and the lower urinary tract symptoms associated with it are a result of a complex of changes that are ongoing within the prostate. Although the precise etiology remains poorly understood, inflammation and cellular stress, steroid hormones such as estrogens and androgens, growth factors, and other contributors appear to play important roles in the disease process. Despite this complexity, significant progress has been made in developing the required tools to begin to subclassify types of BPH according to their phenotypic symptoms; however, much more needs to be done to further define and validate these tools so that they can be routinely deployed in the urology clinic. Nonetheless, these advances are also providing novel therapeutic opportunities for these highly prevalent symptoms and their underlying causes.