Enlargement, or hypertrophy, of the prostate gland is a condition that affects many men of increasing age. It is commonly referred to as benign prostatic hypertrophy, or BPH. The majority of symptoms occur due to growth of the prostate into other structures, with obstructive symptoms commonly ensuing. It is often diagnosed with manual palpation of the prostate via rectal exam and confirmed with an ultrasound examination done rectally.
Chronic obstruction to bladder outflow can result in increased bladder pressures, as it tries to empty its urine load against increasing obstruction. Structures known as diverticulae, which are outpouchings of the bladder that develop in response to increasing pressures, can develop. Eventually failure of the trigone muscle can develop, which results in bladder failure.
Increased Urinary Frequency
The prostate can grow into and obstruct the urethra, which normally functions to carry urine from the bladder to outside the body. As a result, decreased amounts of urine are expelled during bathroom visits and increased residual amounts of urine collect in the bladder. This results in frequent bathroom visits with less urine voided per visit.
Obstruction of the bladder or urethra results in increased amounts of residual urine sitting in the bladder in between voids. This reservoir of urine often serves as a source of infection and can result in chronic urinary tract infections or infections of the bladder (cystitis). Symptoms include pain, discomfort and altered urinary patterns.
If enough residual urine builds up in the bladder due to increasing obstruction, urinary retention can occur. In this situation, the urine backflows into the ureters and even as far back as the kidneys. The feared result of this complication is damage to the kidney, resulting in possible renal failure. Urgent catheterization is often necessary to relieve the pressure building up in the urinary tract.
Increased night time urination, or nocturia, is also common with BPH. Due to the smaller voids during urination (especially before bedtime), the patient ends up having to urinate more frequently, not only during the day but at night as well. This can result in problems for both the patient and his partner as night time sleep patterns are interrupted for frequent urination.
Urinary Stream Problems
Obstruction of the urethra by the prostate can result in problems with the stream of urine. Patients often complain of issues with starting and stopping the flow of urine, which are directly related to the amount of obstruction the prostate is imposing on the urethra. In addition, urinary dribbling after voiding has been noted as well; this can be caused by urine flowing much slower in the urethra due to the obstruction. As a result, even after the bladder has ceased voiding, urine is still slowly flowing in the urethra against the obstruction and the patient reports urine leakage immediately after bathroom visits.
About this Author
Saad Mohammad, M.D., is currently in the process of applying to residency anesthesiology. His first published research occurred in 2009 at the American Thoracic Society National Conference where a poster presentation was accepted and at the Bridgeport Symposium 2009. He began professionally writing in 2009 for Demand Studios as a freelance writer on issues in health and medicine.