Benign prostatic hyperplasia (BPH)

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  Term reserved for histopathologic pattern of smooth muscle and epithelial cell proliferation

  
  
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  Hyperplasia correct term since BPH is characterized by increased number of epithelial stromal cells in periurethral area of prostate (not hypertrophy, which means increase in size)

Sonographic appearance of BPH variable, depending on histopathologic changes

Ultrasound cannot reliably differentiate BPH from prostate cancer

Ultrasound may be used to measure prostate size and PVR as well as evaluate for upper tract obstruction in men with BPH and renal insufficiency

Estimated prostate volume: Prolate ellipsoid formula: Width x height x length x π/6 = W x H x L x 0.52

Prostate, bladder carcinoma

Prostatitis

Bladder outlet obstruction from BPH may occur from urethral constriction from increased smooth muscle tone and resistance (dynamic component) &/or urethral compression from gland enlargement (static component)

Possible bladder sequelae: Trabeculation, diverticula, calculi, detrusor muscle failure

Possible upper tract changes: Ureterectasis, hydronephrosis

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  Can be from 2° vesicoureteral reflux, obstruction from muscular hypertrophy or angulation at ureterovesical junction, sustained high-pressure bladder storage

Avoid including seminal vesicles in transabdominal prostate measurements