What is the most common cause of hydronephrosis in older men with urinary symptoms?

The most common cause of hydronephrosis in older men with urinary symptoms is benign prostatic hyperplasia (BPH). BPH is a non-cancerous enlargement of the prostate gland that commonly occurs as men age. This enlargement can lead to urinary obstruction by compressing the urethra, which subsequently impairs normal urine flow from the bladder and can result in hydronephrosis, which is the swelling of a kidney due to a build-up of urine.

As BPH progresses, it often leads to a variety of urinary symptoms, including increased frequency, urgency, weak stream, and difficulty initiating urination. These symptoms are indicative of bladder outlet obstruction, which, if significant and prolonged, can cause the kidneys to swell (hydronephrosis) due to urine retention.

In older men, other potential causes of hydronephrosis, such as ureteral stones or prostate cancer, may also exist, but BPH remains the most prevalent culprit in this demographic when urinary symptoms are present. It is important for clinicians to recognize the association between BPH and hydronephrosis, as this can guide appropriate management strategies for affected patients.