Vital aging is difficult to define; however, most people would agree that vital aging is something desirable. Voiding problems are frequent in the aging population. Obstruction of the lower urinary tract is often the cause of these problems with subsequent impact on the general quality of life. Etiologic and pathophysiologic investigations not only focus on the prostate itself but also on the interaction between prostate, bladder, and sphincter apparatus and the regulation of the voiding process. Correlation to other disorders as well as therapeutic aspects and issues of sexual function and quality of life are only some issues on the "to do" list in an aging population. A proper patient selection for therapy and a mobilization of the symptomatic patient will also be important targets in the future.