The time the prostate is greater, with possible consequences. Why, that's not entirely clear. There are, however, other than age still some risk factors such as obesity and lack of exercise.
In the past so many was suspected to cause a BPS: gout, bladder irritation, sexually transmitted diseases, sexual abstinence, sexual excesses, colds, horse riding and sedentary lifestyle.Meanwhile, some could be excluded as the sexual activity, but the exact causes are still unknown.
BPH: proliferation of prostate cells
From about the 30th Age occurs in the transition zone of the prostate (especially before and the side of the urethra start, see Anatomy of the prostate ) increasingly to the growth of glands and interstitial tissue. This is called benign prostatic hyperplasia (BPH, benign proliferation of prostate cells, see also terms ). In their formation play androgens (male sex hormones, such astestosterone ) a major role, probably related to estrogens (female sex hormones):
With age, the androgen blood levels fall. In particular, the free testosterone decreases because the blood level of a protein, the sex hormone binding globulin (SHBG) increases. At the same time the blood levels of estrogens that are formed in small amounts in men using the enzyme aromatase from androgens increases. And in the prostate, the activity of the enzyme 5-alpha reductase, testosterone DHT increases largely independent of its blood levels in its biologically active form converts (dihydrotestosterone, and details on all the hormones see sex hormones ).
Thus, the following factors could make the prostate grow over shooting:
- Elevated levels of DHT in the prostate and increased binding sites for androgens on the prostate cells
- Increased estrogen blood levels
- Increased secretion of growth factors in the prostate
- Excessive proliferation of prostate stem cells
- Extended service life due to reduced cell death of prostate cells
BPE: Enlarged prostate
On the basis of cell proliferation in the transition zone occurs initially to displace the remaining tissue. Later, the entire organ is larger, which is called benign prostate enlargement (BPE, see also terms ). Depending on whether more or glands are affected interstitial tissue, the prostate is more or less hard. In addition, smaller and larger node form, partly in non-enlarged regions.And it occurred to districts with tissue swelling, and inflammation Sekretstauung. The latter is not caused by germs, but is a reaction of the body to injury.
BPS: urinary obstruction with consequences
As BPH (cell proliferation), mainly relates to the upper portion of the prostate close to the urethra, the urethra may be narrowed at the beginning. This remains, however, even at a high magnification of sometimes long. Disabled the narrowing of the urine flow from the bladder, it is called a BPO (English benign prostatic obstruction, literally: benign prostatic obstruction, see also terms ).
Possible consequences of the BPO consist firstly in complaints on the lower urinary tract (bladder and urethra, eg urinating), known collectively as LUTS (engl. lower urinary tract symptoms, see also terms ) and discomfort in the upper urinary tract (ureter and kidney; For details about complaints see signs and complications ). Secondly, the BPO can lead to measurable changes (eg Harnrückstau, for details see study ). However, there is only a loose connection between the two, that is, there are both severe changes possible without great discomfort and significant discomfort without major changes. Are subjective or objective evidence exists, it is called a BPS (benign prostatic syndrome). It has a tendency to become stronger with time.
Risk factors for BPS
The most important and non-modifiable risk factor for both disorders (eg LUTS) as well as objective signs of urinary obstruction is age. Other factors are the opposite rather subordinate, however, be influenced by individual well, such as obesity, lack of exercise, diabetes (diabetes mellitus), and chronic prostate inflammation ( prostatitis ). The role of alcohol, smoking and diet (including special diets) is still under discussion.
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