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The role of the endocrine system in BPH development

Benign prostatic hyperplasia (BPH) is the most common agerelated hyperproliferative disorder in men, increasing in incidence from 42% in men 40–50 years of age to 90% by the age of 80
 1A recent review in Andrology looked at factors influencing the pathogenesis of BPH and the onset of lower urinary tract symptoms.1

Androgens play an important role in regulating prostate growth and differentiation during foetal development and puberty and have a permissive role in the adult prostate.1 However the role of androgens in the development of BPH remains controversial.1

Growth factors including insulin-like growth factor, fibroblast growth factor and transforming growth factor, secreted from stromal cells in the prostate, are involved in cross-talk with epithelial cells to maintain cellular homeostasis.1

Changes in the interactions between growth factors and steroid hormones may affect the balance between cell death and proliferation and contribute to the development of BPH. 1

In addition, hormonal or metabolic imbalances may favour chronic inflammation, which is closely related to onset of BPH. 1However, alterations in metabolic or sex hormones (the ratio of androgen to oestrogen) also suggest a role for hypogonadism in prostatic inflammation. 1

The authors conclude that improved knowledge of the different hormonal mechanisms that can influence the development of BPH may highlight new methods for management and diagnosis of patients with this disease.1

Reference list

  1. La Vignera S, Condorelli RA, Russo GI, Morgia G, Calogero AE. Endocrine control of benign prostatic hyperplasia. Andrology 2016; 4(3): 404–411.