Normal Prostate Size in a 70-Year-Old Male
The normal prostate volume for a 70-year-old male is approximately 30-40 mL, with volumes up to 40-50 mL considered within the upper range of normal for this age group. 1
Age-Related Prostate Growth
- Prostate size increases with age, with BPH being nearly ubiquitous in aging males - starting at age 40-45 years, reaching 60% prevalence by age 60, and 80% by age 80 2
- Prostate growth rates increase with age, peaking in men 56-65 years old (approximately 4.15 cc/year), and then declining in older men 3
- The normal prostate reaches about 20 ± 6 grams in men between 21-30 years old and remains relatively constant unless BPH develops 4
Normal Prostate Volume Ranges by Age
- For men in their 70s, prostate volumes of 30-50 mL are typically considered within normal range 1
- The median prostate volume for men in their 70s is approximately 40-45 mL, though there is significant individual variation 5
- Only 4% of prostates in men older than 70 years reach sizes greater than 100 grams, which would be considered significantly enlarged 4
Clinical Significance of Prostate Size
- A prostate volume exceeding 30 mL is considered clinically significant when evaluating treatment options for BPH 2, 1
- Prostate volume assessment is important for determining treatment options, predicting response to 5-alpha reductase inhibitors (5-ARIs), and estimating risk of acute urinary retention 1
- 5-ARIs are more effective in men with larger prostates (>30 cc) or PSA >1.5 ng/mL 1
Correlation Between PSA and Prostate Volume
- PSA levels correlate with prostate volume and both increase with advancing age 5
- A PSA >2.3 ng/mL suggests a prostate volume exceeding 40 mL with 65-70% sensitivity and 70% specificity in men with BPH 1
- The median PSA value for men in their 70s is approximately 1.5 ng/mL, which correlates with normal prostate volumes in this age group 1
Racial Differences in Prostate Volume
- There are racial differences in normal prostate volume and PSA ranges that should be considered when evaluating prostate size 1
- Age-specific PSA reference ranges for men aged 70-79 years vary by race:
Clinical Assessment of Prostate Size
- Digital rectal examination (DRE) can provide a reasonable estimate of prostate size, with high accuracy for very small or very large prostates 6
- DRE findings correlate with prostate volume: flat/normal prostates typically have volumes <30 mL, while moderately/markedly enlarged prostates typically have volumes ≥30 mL 6
- For more precise measurement, transrectal ultrasound is recommended, especially for prostates that feel slightly enlarged on DRE 6