A 62-year-old man presents to his nurse practitioner with complaints of urinary frequency, urinary hesitancy, weak stream, and an inability to completely empty his bladder. His prostate-specific antigen (PSA) level is within normal limits. What is the pathology of this phenomenon?

Choice A reason: Malignant prostatic hyperplasia is not a recognized medical term. Malignancy of the prostate refers to prostate cancer, which typically presents with elevated PSA levels and may include systemic symptoms or nodular findings on examination. This patient’s normal PSA and obstructive urinary symptoms point away from malignancy. Choice B reason: Malignant prostatic hypertrophy is also not a standard diagnosis. Hypertrophy refers to enlargement, but when paired with “malignant,” it implies cancer. Again, the absence of elevated PSA and systemic signs makes this unlikely. Choice C reason: Benign prostatic hyperplasia (BPH) is the most common cause of urinary symptoms in older men. It involves non-cancerous enlargement of the prostate gland, which compresses the urethra and impairs urine flow. Symptoms include frequency, hesitancy, weak stream, and incomplete emptying—all present in this case. Choice D reason: Benign prostatic hypoplasia refers to underdevelopment of the prostate, which is rare and not associated with obstructive urinary symptoms. It does not fit the clinical presentation.