THE RELATIONSHIP BETWEEN BENIGN PROSTATIC HYPERPLASIA AND UROLITHIASIS

Benign prostatic hyperplasia (BPH) and urolithiasis may coexist in older men, but the clinical significance of their association depends on stone location and the presence of functional obstruction. This narrative review examines anatomical, functional, and metabolic mechanisms linking BPH with urinary stone disease, with particular emphasis on bladder calculi. Selected clinical investigations and European Association of Urology guidelines were reviewed. Quantitative evidence included surgical cohorts of 271 and 332 patients, a prospective metabolic comparison, and a randomized treatment study involving 100 men. The findings support an interaction between impaired bladder emptying, intravesical prostatic protrusion, and lithogenic urinary characteristics. Bladder stones were reported in 9.9% of one surgical cohort and in 94 of 332 patients in another. These observations support individualized evaluation of obstruction rather than attributing all urinary stones to prostate enlargement. Management should address stone burden, bladder function, and relevant metabolic susceptibility. The available evidence does not establish BPH as a direct cause of kidney stone formation. Accurate distinction between secondary bladder stones and upper urinary tract calculi is therefore essential for diagnosis, treatment selection, and recurrence prevention.