Extraordinary interest currently exists in the treatment of men over 45 who are referred with the label “prostatism.” This has been generated partly by commercial interest and patients' increased awareness and expectations and partly by the advent of new treatments. Several new drugs to relieve bladder outflow obstruction, including (alpha) adrenergic blockers and 5-(alpha) reductase inhibitors, have been or are about to be licensed. Drug companies have expended huge efforts in increasing patients' and doctors' awareness of prostatic disease.

New techniques to destroy part or all of the prostate have been developed, including thermotherapy, thermal ablation, high intensity focused ultrasonography, transurethral needle ablation, and laser prostatectomy. Added to this are the techniques of intraurethral prostatic stenting and balloon dilatation of the prostate.1

Surveys have shown that urinary symptoms are very common in older men, with prevalences varying from 11% for straining up to 78% for nocturia.2 Interestingly, British and American research has suggested that symptoms are also very common in elderly women.^3,4 Historically, we have used the terms “prostatism” and “symptoms of benign prostatic hyperplasia” to describe lower urinary tract symptoms in men. Yet because these …