A male aged 75 years complained of increasing difficulty with urination for some years prior to death. He had difficulty starting urination, a poor stream, and difficulty stopping. Despite these typical symptoms of prostatic enlargement (hyperplasia), he refused treatment. Eventually, obstruction to the outflow of urine resulted in back pressure, causing dilatation of the ureters (hydroureters) and the renal pelvis and calyces (hydronephrosis). He died as a result of chronic renal failure.