High-volume benign prostatic hyperplasia (BPH, prostate>80g) typically requires invasive surgical intervention per current guidelines. This mini-review explores the pathological characteristics and clinical significance of high-volume BPH, highlighting its inherent heterogeneity. BPH involves epithelial and stromal proliferation. While stromal-dominated hyperplasia (SDH) causes early, severe LUTS in smaller prostates, high-volume BPH often features epithelial-dominated hyperplasia (EDH), leading to significant gland growth but delaying symptom recognition due to less dynamic obstruction. This pathological diversity suggests high-volume BPH is not a uniform condition. Understanding this heterogeneity and identifying its precise drivers are crucial for developing personalized molecular treatments and preventive strategies, potentially reducing invasive surgery for high-volume BPH patients.

Keywords:Benign Prostatic Hyperplasia (BPH); High-volume BPH; Pathological Heterogeneity; Epithelial-dominated hyperplasia (EDH)