ROSH Geriatrics Practice Test

Benign prostatic hyperplasia (BPH) primarily develops in the transitional zone of the prostate. This area surrounds the urethra and is where the glandular tissue responsible for urine flow is located. As men age, hormonal changes, particularly involving testosterone and estrogen, lead to an increase in the number of cells in this zone. This cellular proliferation causes the gland to enlarge, resulting in the symptoms commonly associated with BPH, such as urinary frequency, urgency, and difficulty initiating urine flow.

Understanding the anatomy of the prostate helps clarify why the transitional zone is the site most affected by BPH. The other areas, while essential to prostate structure and function, do not typically experience the same level of hyperplastic growth as the transitional zone. For instance, the peripheral zone is more commonly associated with prostate cancer rather than benign enlargement. Meanwhile, the central zone and fibromuscular stroma have a different composition and are less involved in the pathological process of benign prostatic hyperplasia. Thus, identifying the transitional zone as the primary site of BPH underscores its critical role in age-related changes in prostate health.