[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [Lower urinary tract and male genital system](https://durgical.com/en/general-pathology/areas/urinary-male/) › Benign prostatic hyperplasia

# Benign prostatic hyperplasia

- Lesion

With age, the inner prostate grows into nodules of glands and stroma that squeeze the urethra; it is hyperplasia, not cancer.

Updated Nov 12, 2026

## Key points

- Transition zone and periurethral glands; carcinoma mainly in the peripheral zone.
- DHT from 5α-reductase type 2 (stromal cells) binds androgen receptors and releases growth factors.
- Nodules of glands with two cell layers (basal and luminal) and of fibromuscular stroma.
- Symptoms: hesitancy, weak stream, frequency, nocturia, incomplete emptying, urinary retention.
- Complications: bladder hypertrophy and diverticula, infection, stones, hydronephrosis.

## What it is

Benign prostatic hyperplasia (nodular hyperplasia) affects most men by their seventies. It arises in the transition zone and periurethral area, where androgen-driven growth factors make glands and fibromuscular stroma proliferate. Dihydrotestosterone (DHT), formed from testosterone by 5α-reductase type 2 in stromal cells, is the main driver; that is why 5α-reductase inhibitors shrink the gland. The nodules compress the prostatic urethra and cause outlet obstruction. BPH is not a precursor of carcinoma, which mostly arises in the peripheral zone.

## Structure

- Enlarged gland with well-defined nodules that bulge on the cut surface; solid or with cysts containing milky fluid.
- Hyperplastic glands with papillary infoldings, lined by tall columnar luminal cells over a preserved basal layer; corpora amylacea in lumens.
- Stromal nodules of smooth muscle and fibroblasts; foci of infarction with squamous metaplasia at the edges.

## BPH vs prostatic carcinoma

| Condition | Zone | Glands | Symptoms |
| --- | --- | --- | --- |
| [Benign prostatic hyperplasia](https://durgical.com/en/conditions/benign-prostatic-hyperplasia/) | Transition zone and periurethral | Nodules of glands with basal and luminal layers, plus stroma | Obstruction early |
| [Prostatic carcinoma](https://durgical.com/en/conditions/prostate-cancer/) | Peripheral zone | Small infiltrative glands without basal cells | Often silent until advanced |

## Clinical notes

- Lower urinary tract symptoms are common in older men; a digital rectal exam typically finds a smooth, enlarged, rubbery gland.
- Acute urinary retention can be triggered by infection, cold medications or alcohol.

## Memory aid

Inside zone, inside symptoms: BPH grows around the urethra; cancer grows outside, near the rectum.

## Test yourself

Think of the answer, then tap the question to see it.

## In which zone of the prostate does BPH arise?

The transition zone and periurethral glands.

## Which hormone drives BPH and how is it formed?

Dihydrotestosterone, produced from testosterone by 5α-reductase type 2 in stromal cells.

## Is BPH a precursor of prostate cancer?

No. Both are common in older men, but BPH is not a premalignant lesion.

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## Elsewhere in DurgiPedia

- [Hyperplasia: physiologic and pathologic](https://durgical.com/en/general-pathology/hyperplasia-physiologic-and-pathologic/)
- [Epididymis, vas deferens, seminal glands and prostate](https://durgical.com/en/histology/epididymis-vas-deferens-seminal-glands-and-prostate/)
- [Steroid hormone synthesis (overview)](https://durgical.com/en/biochemistry/topics/steroid-hormone-synthesis/)

## Connections

## Related 4

- [Hyperplasia: physiologic and pathologic](https://durgical.com/en/general-pathology/hyperplasia-physiologic-and-pathologic/)
- [Ureteral and bladder outlet obstruction](https://durgical.com/en/general-pathology/ureteral-and-bladder-outlet-obstruction/)
- [Prostatic adenocarcinoma: Gleason and grade groups](https://durgical.com/en/general-pathology/prostatic-adenocarcinoma-gleason-and-grade-groups/)
- [Urinary tract obstruction and hydronephrosis](https://durgical.com/en/general-pathology/urinary-tract-obstruction-and-hydronephrosis/)

## Related conditions 5

- [Benign prostatic hyperplasia](https://durgical.com/en/conditions/benign-prostatic-hyperplasia/)
- [Acute urinary retention](https://durgical.com/en/conditions/acute-urinary-retention/)
- [Hydronephrosis and obstructive uropathy](https://durgical.com/en/conditions/hydronephrosis-and-obstructive-uropathy/)
- [Urinary tract infection (acute cystitis)](https://durgical.com/en/conditions/urinary-tract-infection/)
- [Kidney stones (urolithiasis)](https://durgical.com/en/conditions/kidney-stones/)

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Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.

Sources: [Benign Prostatic Hyperplasia](https://www.ncbi.nlm.nih.gov/books/NBK558920/) (StatPearls (NCBI Bookshelf), 2024).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/general-pathology/benign-prostatic-hyperplasia/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/benign-prostatic-hyperplasia/