Project Materials

BIOCHEMICAL CHANGES ASSOCIATED WITH BENIGN PROSTATIC HYPERPLASIA (BPH) IN AGEING MEN ATTENDING CLINIC

ABSTRACT

The purpose of this study was to look at the biochemical changes associated with benign prostatic hyperplasia in older males who visited the clinic at the University of Nigeria Teaching Hospital in Ituku-Ozalla, Enugu State, Nigeria. The study comprised 50 men with BPH who attended the clinic, as well as 50 healthy men (control). The samples were separated into 5 groups with varied age ranges (Group 1: Normal control, Group 2: BPH patients ≤ 60 years, on treatment, Group 3: BPH patients ≤ 60 years, not on treatment, Group 4: BPH patients ≥ 60 years, taking therapy, and Group 5: BPH patients ≥ 60 years, not on treatment). BPH positive participants with therapy had significantly higher PSA levels (p < 0.05) than the control group. Subjects under 60 years of age on treatment had significantly higher calcium levels (p < 0.05) compared to group 1 (control). BUN levels were significantly higher (p < 0.05) compared to the usual control. In the same study, zinc levels fell non-significantly (p > 0.05) in the groups studied, while sodium levels in the blood of positive treated and untreated BPH patients were non-significantly (p > 0.05) higher than in healthy people. Iron levels were found to be non-significant (p > 0.05) in persons under 60 years old receiving therapy, but significantly higher (p < 0.05) in the other groups studied.

Chapter one

INTRODUCTION

Benign prostatic hyperplasia (BPH) is the non-malignant swelling of the prostate gland. It refers to stromal and glandular epithelial hyperplasia in the prostate’s periurethral transition zone, which surrounds the urethra. BPH is clinically manifested as lower urinary tract symptoms (LUTS), which include irritative (urgency, frequency, nocturia) and obstructive symptoms (hesitancy, a weak and interrupted urine stream, straining to initiate urination, and a sensation of incomplete bladder emptying) (Miller and Tarter, 2009).

Prolonged blockages can result in acute urine retention (AUR), recurrent urinary tract infections (UTI), haematuria, bladder calculi, and renal insufficiency (Curtis 2006).

BPH-related LUTS become more common as people get older. Moderate to severe symptoms affect 40 and 80% of males after the age of 60 and 80 years, respectively. Almost all men get microscopic BPH by the age of 90 (Ogunbiyi and Shittu, 1999).

It is sometimes referred to as a quality of life disorder since it impairs a person’s capacity to commence or terminate urine flow (the symptoms interfere with routine activities) and lowers one’s sense of well-being.

The causes of BPH are unknown, however overgrowth of smooth muscle tissue and glandular epithelial tissue is thought to be caused by a variety of reasons, including ageing, late activation of cell growth, hereditary factors, and hormonal changes (Wang and Jicun 2015).

1.1 Epidemiology.

Benign prostatic hyperplasia (BPH) is a histological diagnostic characterised by uncontrolled growth of connective tissue, smooth muscle, and glandular epithelium in the prostatic transition zone (Auffenberg et al. 2009).

Prostate tissue consists of two main components: a glandular element made up of secretory ducts and acini, and a stromal element made up primarily of collagen and smooth muscle.

In BPH, cellular proliferation causes increased prostate volume and stromal smooth muscle tone. McNeal (1984) describes two stages of BPH development.