Pathophysiology

Although prostate cancer is increasingly common, the incidence of AUR secondary to malignant disease is very low, probably less than 1 % of cases of AUR seen in practice. Having said that, there may be a significant proportion of men, especially those over the age of 70, who present in AUR who have both BPH and undiag-nosed prostate cancer, and most men with prostate cancer will have BPH to a certain extent. Therefore, the mechanisms of BOO are similar to those in BPH, and prepresentation LUTS will also tend to be similar. In some cases, however, the obstruction to voiding will be directly related to local tumor burden causing either compression of the prostatic urethra, or in some cases local invasion into the urethra, seminal vesicles, or ejaculatory ducts, causing mechanical obstruction or stricturing of the prostatic urethra (Anson et al. 1993; Sandhu et al. 1992). The effects on the detrusor are similar to those seen in BPH.

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