Benign prostatic hyperplasia (BPH)—also known as benign prostatic enlargement (BPE) or an enlarged prostate—is the most common benign (noncancerous) growth process in men. In BPH, prostate cells accumulate and the organ tissue becomes overgrown, or enlarged. Tissue overgrowth produces nodules in the transition zone of the prostate. The increase in prostate cells is due to a slowing of apoptosis (normal programmed cell death), not an increase in cell production.
What triggers BPH is not well understood, but aging and testosterone (the predominant male sex hormone) are believed to be the primary influences on its development. The female sex hormone estrogen (produced in small amounts in men) also may play a role, perhaps when a man’s testosterone production declines and the balance of the two hormones is altered.
As is true for prostate cancer, BPH occurs more often in Western industrialized countries (the United States, the United Kingdom, and Canada, for example) than in Eastern countries (such as Japan and China). BPH appears to be more common among black men than among white men, and some evidence suggests that a family history of BPH may increase the risk. Being overweight, especially with extra fat concentrated around the abdomen, increases the risk of developing BPH.
Treatment for the condition is necessary only if symptoms begin to interfere with quality of life. The main treatment options for BPH include medications that either shrink the prostate or relax the muscle tissue that constricts the urethra; surgery to remove, ablate, or vaporize excess prostate tissue; and heat therapy, called thermotherapy, that eliminates excess tissue.