RT Book, Section
A1 Jameson, J. Larry
A1 Fauci, Anthony S.
A1 Kasper, Dennis L.
A1 Hauser, Stephen L.
A1 Longo, Dan L.
A1 Loscalzo, Joseph
SR Print(0)
ID 1167064410
T1 Prostate Hyperplasia and Carcinoma
T2 Harrison's Manual of Medicine, 20e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260455342
LK accessmedicine.mhmedical.com/content.aspx?aid=1167064410
RD 2023/03/22
AB Enlargement  of  the  prostate  is  nearly  universal  in  aging  men.  Hyperplasia  usually  begins  by  age  45  years,  occurs  in  the  area  of  the  prostate  gland  surrounding  the  urethra,  and  produces  urinary  outflow  obstruction.  Symptoms  develop  on  average  by  age  65  in  whites  and  60  in  blacks.  Symptoms  develop  late  because  hypertrophy  of  the  bladder  detrusor  compensates  for  ureteral  compression.  As  obstruction  progresses,  urinary  stream  caliber  and  force  diminish,  hesitancy  in  stream  initiation  develops,  and  postvoid  dribbling  occurs.  Dysuria  and  urgency  are  signs  of  bladder  irritation  (perhaps  due  to  inflammation  or  tumor)  and  are  usually  not  seen  in  prostate  hyperplasia.  As  the  postvoid  residual  increases,  nocturia  and  overflow  incontinence  may  develop.  Common  medications  such  as  tranquilizing  drugs  and  decongestants,  infections,  or  alcohol  may  precipitate  urinary  retention.  Because  of  the  prevalence  of  hyperplasia,  the  relationship  to  neoplasia  is  unclear.