Pathogenesis (development of disease)
The cause of benign (benign) prostatic hyperplasia (prostate enlargement) is still unknown.
Various hypotheses are discussed that may lead to the hyperplasia:
- Influence of growth factors
- Dihydrotestosterone hypothesis (DHT hypothesis):
- Increased intracellular DHT levels.
- Increased 5-alpha-reductase activity
- Increased androgen receptor levels
- Increased estrogen serum levels with concomitant low testosterone serum levels.
- Stem cell proliferation (abnormal proliferation of stem cells).
- Excessive tissue longevity (theory of reduced cell death: increased estrogen levels lead to prolonged prostate cell longevity).
In benign prostatic hyperplasia, nodular remodeling of the prostate occurs in the transitional zone. Since the prostate gland surrounds the urethra (urethra), the urethra can be significantly narrowed with a corresponding increase in size, which leads to corresponding symptoms (see there).
Etiology (Causes)
Biographic causes
- Age of life – increasing age
Behavioral causes
- Nutrition
- Micronutrient deficiency (vital substances) – see Prevention with micronutrients.
- Physical activity
- Sitting for long periods ≥ 10 hours per day (+16% increased risk of LUTS (Lower Urinary Tract Symptoms)).
