Ageing of the urogenital system and natural history of benign prostatic hyperplasia.

During the last decade, studies were led to better understand theimpact of the ageing of the urogenital system and of the occurrenceof a benign prostatic hyperplasia on the quality of life. A betterknowledge of the disorders engendered by these two almost inevitableevents had become necessary for two reasons: on one hand thequick progression of the average age of the population, and on theother hand the launch on market of long course treatments aiming attreating an increasing number of patients. The development of benignprostatic hyperplasia is the result of hormonal modificationsoccurring in men in their fifties. These hormonal changes lead to aseries of phenomena affecting the stroma and the glandular tissue.Fifty per cent of 50-year-old men start developing benign prostatichyperplasia, increasing to 80% of 80-year-old men. The etiopathogenyof mictional and genital symptoms which appear in this agebracket is never simple to understand because the occurrence ofbenign prostatic hyperplasia is accompanied by an ageing of theurinary tract which affects the vesical reservoir in particular. Inorder to better target the therapeutic choice, the clinician has toidentify as clearly as possible the role of urogenital modifications incausing the urinary symptoms which motivate the consultation.