URINARY PROBLEMS

Do I have prostate disease?

Changes in urination pattern may well be associated with some form of prostate disease.

Men with prostatitis usually also have other symptoms that are associated with infection, including fever, tiredness and muscle pain.

It is important to note that a number of men with BPH or prostate cancer may not have many, or any symptoms. It is therefore important for men over the age of 50 years to have their prostate checked by the doctor every year. Men who have a family history of prostate cancer should have regular prostate checks before the age of 50.

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What are the main signs of prostate disease?

The close location of the prostate around the urethra means that any enlargement of the gland may block the urethra and interfere with the flow of urine and changes in urination pattern.

The first sign that there may be prostate problems may be when:

• A man has difficulty in passing urine;
• A man experiences the urge to pass urine more frequently.

Some men may experience pain at the base of the scrotum and penis (referred to as perineal pain).

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What are the symptoms?

A number of men with prostate disease may not have many or any symptoms.

Those men who do have symptoms usually find that there are noticeable changes to urination because prostate disease affects the part of the prostate around the urethra.

If symptoms develop, they are usually described as either obstructive or irritative, but other symptoms may also happen.

Obstructive symptoms

• Hesitancy (a longer than usual wait for the stream of urine to begin);
• Weak and poorly directed stream of urine;
• Straining to urinate;
• Dribbling after urination has finished or an irregular stream;
• Urinary retention (not all the urine is passed from the bladder making the need to urinate more often);
• Overflow or paradoxical incontinence (urine overflows from a full bladder uncontrollably even though normal urination cannot be started).

Irritative symptoms

• Urgency (an urgent feeling of needing to urinate);
• Frequency (a short time between needing to urinate);
• Nocturia (a need to pass urine more than twice at night).

Other symptoms

• Perineal pain (pain at the base of the scrotum and penis);
• Dysuria (painful urination);
• Haematuria (blood in the urine).

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What is LUTS?

LUTS, or lower urinary tract symptoms, is a common term used to describe the range of urinary symptoms that may be linked with prostate disease.

LUTS can be described as mild, moderate or severe, depending on how much the symptoms are bothersome to the man’s general lifestyle and activities.  Other issues not directly related to the man’s urinary symptoms may make the symptoms more bothersome, for example reduced physical movement may make it more difficult for a man to get to the toilet in time.

Prostate disease is not the only cause of LUTS.  LUTS can happen after changes in the workings of the bladder, urethra and/or prostate.  Some other causes of LUTS include neurological disease (such as stroke, Parkinson’s Disease), some medicines, infections and an irritable bladder.

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What should be done if urination problems exist?

Any symptoms involving changes to urination should be discussed with a local doctor, particularly if they are affecting a man’s quality of life or interfering in his normal daily activities.

Many people think that urinary symptoms in men are a sign of prostate cancer. This is not true. Sometimes, but less commonly, prostate cancer is present, but urinary symptoms are most often caused by prostate enlargement.

It is important to have any urinary problems checked by a doctor, discuss the possibility of prostate cancer and make a diagnosis of the problem.

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Do symptoms always happen?

Not all men get symptoms from prostate disease.  For some men, the symptoms are quite mild or non-existent and treatment is not needed.  It is also true that early stage prostate cancer does not usually produce urinary symptoms.

For these reasons, men over the age of 50 years, particularly those who have a family history of prostate cancer amongst brothers, fathers and uncles, may need to think about having a prostate examination each year.  During a prostate check, the doctor assesses the size, shape and feel of the prostate gland. 

There is much debate about the benefits of early detection and treatment of prostate cancer.  Information about risks and benefits should be discussed with a doctor before a decision is made about testing.  Any concerns should be talked about with the doctor.

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Should I see a doctor?

BPH and prostate cancer happen more commonly in men over the age of 50. Men who are concerned about prostate disease should see their doctor, who can perform an examination of their prostate gland. This is done by having a digital rectal examination (DRE), where the doctor places a finger in the back passage (rectum) to check the size, shape and feel of the prostate gland.

Any symptoms involving changes to urination should be mentioned to the doctor, particularly if they are causing any change to a man's quality of life or interference in his normal daily activities.

A local doctor may refer a man to see a specialist (urologist).

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