Pathology

Benign prostatic hypertrophy is characterised by the formation of large, fairly discrete nodules in the periurethral region of the prostate.

• with the expansion of this periurethral transitional zone, it pushes against the surrounding prostatic glandular tissue proper, resulting in compression of the outer peripheral zone into a false capsule. This distribution contrasts with that of prostatic carcinoma which mainly occurs peripherally in the glandular tissue proper (1)

Hyperplasia affects both glandular and connective tissue elements but in varying degress.

• predominantly there is glandular proliferation of the submucous group of glands in the transitional zone, forming a nodular enlargement (1)
• the nodules tend to be soft, yellow-pink and well demarcated from the surrounding more grey, compressed prostatic tissue. In enlargement primarily due to fibromuscular stromal hypertrophy and hyperplasia, the nodules tend to be tough, fibrous, pale grey and less clearly demarcated from the surrounding tissue.

The nodular enlargement may be extensive. Symptoms relate to narrowing of the urethral canal which may cause partial or complete urethral obstruction. The hypertrophied gland may weigh up to 800 grams.

Reference:

• (1) Bailey & Love’s short practice of surgery. 25th edition