The primary concern is that of the quality of aging.

The urological considerations that may impact this aspect of life are:

Prostate and urinary function

• benign prostatic enlargement is inevitable and progresses with age
• evaluation and assessment is usually office based and only minimally invasive
• there are multiple treatments depending on the disease process...the commonest are:
  • medication
          alpha blockers ...act quickly and are the most effective
          5-alpha reductase inhibitors ...act slowly and are usually less effective
  • TUMT ...transurethral microwave thermotherapy…usually done in office and minimally invasive
  • TURP ...transurethral resection of the prostate ...usually done in hospital and now often done with a laser

Sexual function

• please refer to the section on ED and PD
• these are complex issues that can always be appropriately, and effectively, addressed

Hormonal status

• male hormone declines 1.5% per year starting at age 30 years
• many different ways to define deficiency
• deficiency has health implications ...a low Testosterone level is associated with a
  • 33% greater risk of death
  • increased risk of
  • type 2 diabetes
  • metabolic syndrome
  • cardiovascular disease
         this is the leading cause of death in men with prostate cancer
• Testosterone replacement can help prevent these issues

The purpose of evaluation, and treatment, is to synchronously minimize the deleterious effects while maximizing the beneficial aspects. In turn this should improve both the quality, and the duration, of life.