Background and Objectives: Lower urinary tract symptoms (LUTS) are highly prevalent among aging men and have traditionally been attributed primarily to benign prostatic hyperplasia (BPH) and bladder outlet obstruction (BOO). However, growing evidence suggests that bladder-related mechanisms play a critical and often underrecognized role. This review aims to summarize current evidence on the contribution of the aging bladder to LUTS pathophysiology and to explore the therapeutic implications in men with BPH. Materials and Methods: A comprehensive literature search was conducted in PubMed/MEDLINE, Scopus, and Web of Science for studies published between January 2010 and April 2025. Search terms included combinations of “aging bladder”, “detrusor dysfunction”, “LUTS”, “BPH”, “bladder outlet obstruction”, “ischemia”, “overactive bladder”, and “detrusor underactivity”. Eligible studies included narrative reviews, systematic reviews, meta-analyses, clinical studies, and translational research addressing bladder aging and its clinical implications. A narrative synthesis approach was used due to heterogeneity in study design and outcomes. Results: A total of 43 studies were included in the qualitative synthesis. The evidence indicates that LUTS in older men result from multifactorial processes involving not only prostatic enlargement but also bladder dysfunction. Aging-associated changes include detrusor remodeling, impaired compliance, neural alterations, and vascular insufficiency, particularly chronic ischemia and oxidative stress. These mechanisms contribute to both detrusor overactivity and underactivity, providing a unifying framework for storage and voiding symptoms. Importantly, the severity of LUTS does not consistently correlate with prostate size or degree of obstruction. Conclusions: LUTS in aging men should be considered a complex condition involving both bladder and outlet factors. A bladder-centered perspective may improve patient stratification and therapeutic outcomes. Integrating bladder-targeted therapies with conventional BPH management supports a more personalized and effective approach to care.

Chromophobe RCC (ChRCC) carries the best prognosis among all RCC subtypes, yet it lacks a proper grading system. Various systems have been suggested in the past, causing much controversy, and Avulova et al. recently proposed a promising four-tier grading system that takes into consideration tumor necrosis. Dysregulation of the mammalian target of the rapamycin (mTOR) pathway plays a key role in ChRCC pathogenesis, highlighting its molecular complexity. The present retrospective study aimed to evaluate the prognostic factors associated with a more aggressive ChRCC phenotype. Materials and Methods: Seventy-two patients diagnosed with ChRCC between 2004 and 2017 were included in our study. Pathology reports and tissue blocks were reviewed, and immunohistochemistry (IHC) was performed in order to assess the expressions of CYLD (tumor-suppressor gene) and mTOR, among other markers. Univariate analysis was performed, and OS was assessed using the Kaplan–Meier method. Results: In our study, 74% of patients were male, with a mean age of 60 years, and the mean tumor size was 63 mm (±44). The majority (54%) were followed for more than 10 years at intervals ranging between 44 and 222 months. The risk of death was significantly higher for patients that were classified as Grade 4 in the Avulova system (HR: 5.83; 95% CI, 1.37–24.7; p: = 0.017). As far as the IHC is concerned, mTOR expression was associated with an HR of 8.57 (95% CI, 1.91–38.5; p = 0.005), and CYLD expression was associated with an HR of 17.3 (95% CI, 1.57–192; p = 0.02). Conclusions: In our study, the Avulova grading system seems to be positively correlated with OS in patients diagnosed with ChRCC. Furthermore, an elevated mTOR expression also shows a negative correlation with OS, whereas an elevated CYLD expression does not seem to exert a protective role. However, because only a small proportion (4.2%) of our patients died due to ChRCC, despite the long follow-up period, the results must be interpreted with caution. Further research is needed to validate our findings.

Background/Objectives: Sexual dysfunction is highly prevalent in men with chronic kidney disease (CKD), but longitudinal data across the CKD spectrum, particularly those directly comparing non-dialysis CKD with haemodialysis, are limited. We aimed to characterise longitudinal patterns in erectile and broader sexual function over three years, focusing on persistent between-group stratification and change over time in men with CKD versus community controls, and to identify clinical predictors of poorer outcomes. Methods: We conducted a three-year prospective cohort study in three groups of adult men: a group on haemodialysis, a group with non-dialysis CKD stages 3A/3B, and age-matched community controls without known kidney disease. The primary endpoint was the erectile function (EF) domain score of the International Index of Erectile Function (IIEF-15), assessed annually; the IIEF-15 total score and remaining domains were the secondary outcomes. Participants’ health-related quality of life (EQ-5D-5L), age, and diabetes status were recorded. Linear mixed effects models with participant-level random intercepts estimated the effects of group, year, and group × year, adjusted for age, EQ-5D-5L, and diabetes. Results: We enrolled 267 men (haemodialysis n = 96; CKD n = 88; and controls n = 83). At every time point, EF and other IIEF-15 domain scores showed a graded pattern with controls being the highest, CKD being intermediate, and haemodialysis the lowest. group × year interactions were not significant, indicating parallel trajectories without differential decline between groups over three years. Having a lower EQ-5D-5L, an older age, and diabetes—particularly type 2—were independent predictors of poorer IIEF-15 scores across domains. Conclusions: Male sexual function in CKD is persistently and gradually impaired along the renal disease spectrum, with patients on haemodialysis faring the worst and with no evidence of divergent longitudinal change. Routine EF screening, systematic attention to patients’ quality of life, and aggressive management of diabetes should be embedded in CKD care pathways, and renal-appropriate erectile dysfunction interventions should be considered earlier and more systematically.