Life After Age 85 will Likely Include Benign Prostatic Hyperplasia

Joyce So, BSc

Benign prostatic hyperplasia (BPH) is a non-malignant condition of nodular but symmetrical enlargement of the prostate in the peri-urethral region, likely due to androgen imbalances associated with aging. It is common in men over the age of 40, regardless of ethnic background. The incidence of BPH can be as high as 50% by the age of 60, and 90% by age 85.1 This makes BPH a condition of increasing importance as the population ages.

Because of its proximity to the urogenital tract, prostatic enlargement most commonly presents as obstructive lower urinary tract symptoms, although some are asymptomatic (see Figure 1). Bladder outlet obstruction, causing incomplete emptying and subsequent rapid filling, results in urgency, frequency, and nocturia as the primary presenting complaints. The weak and reduced urinary stream in BPH produces hesitancy, intermittency and post-void dribbling. Urinary retention and stasis predispose BPH patients to infection, which can cause bladder and upper urinary tract inflammation, as well as calculus formation. In severe, prolonged obstruction, there is a risk of hydronephrosis and progressive renal failure and azotemia.

Figure 1. Location of the prostate gland in relations to the urogenital tract