Benign prostatic hyperplasia (BPH) in older men is characterised primarily by which of the following changes in the prostate gland?

Introduction / Context:
Benign prostatic hyperplasia, often abbreviated as BPH, is a very common condition in older men. It involves changes in the prostate gland that can lead to urinary symptoms. Understanding what BPH actually means helps distinguish it from other male reproductive disorders, such as prostate cancer or epididymis problems. This question asks which statement best characterises BPH.

Given Data / Assumptions:

• The disorder named is benign prostatic hyperplasia (BPH).
• The options mention loss of function, enlargement of the prostate, epididymis issues, and none of the above.
• We assume standard clinical descriptions of BPH.
• Benign in this context means noncancerous, and hyperplasia means increase in cell number.

Concept / Approach:
Benign prostatic hyperplasia refers to a noncancerous increase in the size of the prostate gland, usually due to proliferation of glandular and stromal tissue. This enlargement can compress the urethra that passes through the prostate, leading to symptoms such as difficulty starting urination, weak stream, and frequent urination. It does not mean the prostate loses all function, nor does it primarily involve structures like the epididymis. Therefore, the best description is noncancerous enlargement of the prostate that may obstruct urine flow.

Step-by-Step Solution:
Step 1: Break down the term benign prostatic hyperplasia. Benign means noncancerous, prostatic refers to the prostate gland, and hyperplasia means an increase in the number of cells leading to enlargement. Step 2: Recognise that BPH typically occurs in aging men and is associated with an enlarged prostate situated around the urethra. Step 3: Understand that as the prostate enlarges, it can compress the urethra and affect urine flow from the bladder. Step 4: Note that BPH is different from prostate cancer, which involves malignant growth, and from epididymis disorders, which affect a different structure attached to the testis. Step 5: Evaluate the options and choose the one that mentions noncancerous enlargement of the prostate gland with potential obstruction of urine flow.

Verification / Alternative check:
Medical references describe BPH as enlargement of the prostate that is histologically benign, meaning the cells do not show cancerous changes. Patients with BPH often present with lower urinary tract symptoms such as hesitancy, weak stream, and nocturia due to compression of the urethra. There is no description of complete loss of prostate function in typical BPH definitions, nor is the epididymis identified as the primary site of disease. This confirms that noncancerous enlargement of the prostate is the defining feature of BPH.

Why Other Options Are Wrong:
Complete loss of function of the prostate gland with no enlargement is wrong because BPH is specifically about enlargement and does not necessarily imply total functional failure. Disease mainly affecting the epididymis rather than the prostate is incorrect because BPH involves the prostate itself; the epididymis is a separate structure involved in sperm maturation. None of the above changes describe benign prostatic hyperplasia is also wrong since option B accurately describes BPH.

Common Pitfalls:
A common pitfall is to confuse BPH with prostate cancer and assume that any prostate enlargement is malignant. Another mistake is misunderstanding the word hyperplasia as meaning decreased function rather than increased cell number leading to enlargement. To avoid these errors, remember that benign indicates noncancerous, and hyperplasia indicates growth in cell number. When you see benign prostatic hyperplasia, think of a noncancerous enlarged prostate that can press on the urethra and cause urinary symptoms.

Final Answer:
The correct choice is Noncancerous enlargement of the prostate gland that can obstruct urine flow, because this describes the key feature of benign prostatic hyperplasia.