NURS 6501: Final Exam: Please contact Assignment Samurai for help with NURS 6501: Final Exam or any other assignment. Email: assignmentsamurai@gmail.com A patient with benign prostatic hyperplasia has increased post-void residual volume, indicative of bladder outlet obstruction. Which of the following best explains the pathophysiological mechanism behind this obstruction? Group of answer choices

• Reduced testosterone levels leading to prostatic tissue scarring
• Increased smooth muscle relaxation in the bladder neck
• Increased cortisol levels causing prostate tissue shrinkage
• Hyperplasia and hypertrophy of prostatic tissue leading to urethral compression

The correct answer is: Hyperplasia and hypertrophy of prostatic tissue leading to urethral compression   Explanation: Benign prostatic hyperplasia (BPH) causes bladder outlet obstruction primarily due to:

1. Hyperplasia (↑ cell number) and hypertrophy (↑ cell size) of prostatic stromal and epithelial cells in the transition zone of the prostate.
2. This enlarges the prostate, compressing the prostatic urethra, leading to:
   • Increased post-void residual volume (incomplete bladder emptying).
   • Obstructive symptoms (weak stream, hesitancy, urinary retention).

Why Not the Others?

• Reduced testosterone levels causing scarring: BPH is not caused by low testosterone; it’s linked to dihydrotestosterone (DHT) stimulation of prostate growth.
• Increased smooth muscle relaxation in the bladder neck: BPH involves increased smooth muscle tone (α1-adrenergic mediated), not relaxation.
• Increased cortisol causing prostate shrinkage: Cortisol does not shrink the prostate; BPH is driven by androgens (DHT) and aging.

Key Pathophysiology:

• DHT (derived from testosterone via 5α-reductase) promotes prostate growth.
• α1-adrenergic receptors in the prostate increase smooth muscle tone, worsening obstruction.

Thus, prostatic tissue hyperplasia/hypertrophy is the core mechanism.