What is hyperplasia?
Hyperplasia means that extra cells are present in an organ or tissue. The cells themselves are usually normal, if sometimes enlarged, although in some cases atypical cells (called atypia) may develop. As cells proliferate, they cause the organ or tissue to enlarge while affecting normal spacing and ordering. In some cases, the enlargement is a normal stage in a physiological process, such as the enlargement of breasts for breast-feeding. In others, it may be unsightly but harmless, as in sebaceous hyperplasia: small, soft, yellow growths on the face.
Endometrial hyperplasia is enlargement of the endometrium, the lining of the uterus, probably from elevated levels of estrogens. Most instances are benign and cause no symptoms. Hyperplasia with atypia is cause for concern, because in about a quarter of cases it develops into cancer.
Benign prostatic hyperplasia (BPH) is enlargement of the prostate gland by a proliferation of cells in connective tissue and adjacent epithelial tissue. It is common in men over forty years of age and may cause difficult, frequent, or painful urination.
Congenital adrenal hyperplasia is a genetic malformation of the adrenal glands that prevents them from producing the hormones cortisol and aldosterone. Without them, the body produces too much of the male sex hormone androgen. In females, this may lead to abnormal or absent menstruation, genitals that look both male and female, or excessive hair growth. In males, malformed genitals may develop, and there may be early development of male characteristics. In severe cases, newborn infants may experience heart arrhythmias, dehydration, electrolyte imbalances, and vomiting.
For the majority of hyperplasia cases, when there are no or mild symptoms, physicians do not recommend treatment. Instead, the condition is monitored regularly—the “wait and watch” approach. However, for severe cases, surgery is often used. For endometrial hyperplasia, removal of the uterus (hysterectomy) is preferred. For the prostate, several methods exist to remove the enlarged portion: open surgery, surgery with a resectoscope through the urethra, and laser procedures to destroy excess tissue. Various methods of thermotherapy—heating tissue to destroy or shrink it—use water, microwaves, ultrasound, or radio-frequency energy.
Medications can also reduce the symptoms of hyperplasia. Progestrones are used for endometrial hyperplasia. Several drugs to inhibit production of hormones likewise treat benign prostatic hyperplasia, and other medications may be given to relax the muscles of the prostate and bladder to make urination easier. Medications containing a form of cortisol control androgen levels in the treatment of congenital adrenal hyperplasia.
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