Zusammenfassung
Die Pathophysiologie von benigner Prostatahyperplasie (BPH)/benigner Prostatavergrößerung (BPE)/unterer Harntraktsymptomatik (LUTS) wird nach wie vor nur inkomplett verstanden und ist ein multifaktorieller, komplexer, altersassoziierter Prozess. Die dominante Rolle des Androgenhaushalts, vor allem des Androgenrezeptors, für die Entwicklung einer BPH/BPE ist seit Jahren gut dokumentiert. Daneben spielen die intraprostatische Entzündung, das Mikrobiom, Zytokine, Dysregulation von Proliferation und Apoptose, Lebensstilfaktoren, das metabolische Syndrom und eine Gewebsmodellierung eine Rolle, nur um die wesentlichen Faktoren aufzuführen.
Die untere Harntraktsymptomatik wird wesentlich durch die drei urodynamischen Muster Blasenauslassobstruktion, Detrusorüberaktivität und Detrusorunterfunktion bestimmt, welche isoliert oder in verschiedenen Kombinationen auftreten können.
Trotz relevanter Fortschritte im Verständnis der Pathogenese von BPH/BPE/LUTS wurde in den letzten zwei Jahrzehnten kein neues Präparat in die klinische Routine eingeführt, welches das Prostatavolumen beeinflusst.
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Madersbacher, S. (2022). Pathophysiologie. In: Netsch, C., Gross, A.J. (eds) Benignes Prostatasyndrom. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-64334-1_3
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