PHYSICAL EXAMINATION

LABORATORY STUDIES

DIAGNOSIS

Benign prostatic hyperplasia

PATHOPHYSIOLOGY OF KEY SYMPTOMS

Urine produced by the kidneys is transported through the ureter and stored in the bladder before elimination from the body. During the micturition reflex, contraction of the detrusor muscle of the bladder wall increases pressure in the bladder. This, along with the relaxation of the internal and external sphincter, allows urine to exit the body through the urethra.

In males, the urethra passes through the center of the prostate gland before entering the penis (Fig. 87-1). Enlargement of the prostate gland can cause external compression of the ureter and impair micturition. The patient’s symptoms—difficulty in urination, bladder distention, weak urinary stream, and urinary frequency—result from obstruction of the ureter and impaired emptying of the bladder.

FIGURE 87–1 The paired corpora cavernosa provide most of the volume of the penis. Dilation of the blood vessels supplying the corpora cavernosa allows them to become engorged with blood, causing the penis to become erect and rigid.