BPH

Voiding Dysfunction In Men

There are two essential systems in the pelvic area among men. This includes the urinary and reproductive systems.

The urinary system ensures urine can be moved outside of the body. The productive system creates sperm and expels it during sexual intercourse. 

There are specific urinary dysfunctions and problems that men face. Some of these conditions are caused by a problem with the urinary system itself.

In some cases, however, issues with the reproductive system may lead to urinary symptoms. A good example would be prostate problems causing urinary problems. 

We look at voiding dysfunction among men in this post. We consider why men experience urinary problems.

We also look at how prostate issues can lead to lower urinary tract symptoms. This post will also provide guidance on the current treatments available for men with urinary problems. 

Cause Of Urinary Problems As Men Age

Age is something that we cannot prevent. It is a natural part of life, and it comes with several changes. On the outside, men experience wrinkles, grey hair, and a reduction in muscle mass1. 

It is not only the outer appearance of the body that is affected by age. Several changes happen on the inside too. As these changes occur, some men may experience complications. A common difficulty lies with the urinary tract

One study2 examined the prevalence of urinary incontinence among a male population. The study looked at how it differs between different age groups. There was a low prevalence in younger groups. Between the ages of 60 and 64, about 11% of men were found to be affected. The prevalence of urinary incontinence increased to 31% among men older than 64 years. 

In the majority of cases where urinary problems occur in older men, issues with the prostate are to be blamed. 

Previous studies have already shown that the risk of conditions like prostatitis and benign prostatic hyperplasia, or an enlarged prostate, significantly increases with age. 

As men age and their risk of these prostate conditions become elevated, they also experience a higher risk of urinary issues. 

At the same time, it is essential to note that not all urinary dysfunction cases are linked to prostate problems. Other issues can also affect the urinary tract. 

Here are a few examples of other factors that may lead to urinary symptoms:

  • Men with a lower urinary tract infection may experience a burning sensation when they urinate. They may also need to urinate more frequently. Other symptoms can also develop. 

  • When there are stones that develop in the urinary tract, these may also lead to similar symptoms. Kidney stones, bladder stones, and stones in the urethra can all lead to urinary symptoms to develop. 

  • Some conditions that directly affect the urethra, such as an inflammatory illness, may lead to a weak flow of urine. There may be other symptoms that accompany the reduced urine flow too. 

Symptoms Of Urinary Problems

Various symptoms in men may indicate urinary problems. Many of these symptoms are considered general. This means they are not associated with only a single type of condition that may lead to these symptoms. Multiple conditions can cause the same urinary problems in a man.

Understanding the symptoms is considered the first step to taking appropriate action. When a man notices these symptoms, they should ensure they talk to their doctor. This will help to ensure a diagnosis can be made. 

Some symptoms that may indicate a urinary problem in men include:

  • There may be a consistent urge to urinate. 

  • When the man gets to the bathroom, they may not be able to urinate. Sometimes, only a few dribbles of urine will exit their urethra. 

  • A lot of men experience nighttime urination. A person may notice they have to get up to urinate more frequently at night. In severe cases, the nighttime urination may even interfere with the man’s ability to sleep. 

  • Some men may experience urinary urgency. This causes a sudden feeling to urinate. The urge may also be very strong. There are times where urinary urgency may even cause a man to be unable to get to a bathroom fast enough. 

  • Some men experience dribbling after they urinate. 

  • There may sometimes be a sensation that the man’s bladder was not able to empty completely after they urinated. If they try to urinate again directly after, noting may be expelled from the urethra

  • There are cases where a man may struggle to start urinating. The urine stream may also be slow and weak. 

Many of these symptoms do not necessarily mean that there is something serious going on. In most cases, it will be related to a minor problem. A simple treatment may be provided. In some cases, the doctor may rather advise the patient do make some lifestyle changes. 

Some symptoms may indicate a more serious problem. In these cases, a doctor will take note and usually perform additional tests. 

More serious symptoms that patients should ensure they tell their doctor include:

  • The complete inability to urinate is another critical factor to consider. This is generally considered a medical emergency. 

  • There may be pain when urinating. Some men have complained about pain when they ejaculate too. 

  • It is vital to take note of any discharge that comes from a man’s penis. This may also indicate a more serious problem causing the urinary symptoms. 

  • Severe urinary incontinence also needs to be considered something to worry about—the same accounts for men who experience continuous urinary incontinence. 

Problems With Enlarged Prostate Gland

Most men with urinary problems have an issue that affects their prostate gland. 

The prostate gland is part of the male body’s reproductive tract. It is connected to the urethra and the testicles through a series of tubes.

The testicles produce sperm. The sperm is then sent toward the prostate. This gland then produces a fluid. It is generally referred to as prostate fluid. The fluid combines with the sperm that came from the testes. The combination of sperm and the prostate fluid is what people know as semen. 

When a man ejaculates, the semen is pushed from the prostate gland into the urethra. 

An enlarged prostate gland is a prevalent problem in men. It is a condition also known as benign prostatic hyperplasia. 

A man with benign prostatic hyperplasia has a prostate that became enlarged. The enlargement of the prostate causes it to push against both the urethra and the bladder. This can lead to a restriction in the man’s urethra. In turn, several symptoms may occur. 

There are also complications associated with prostate enlargement that may cause further symptoms to develop. An example is a urinary tract infection. When a man has an enlarged prostate that goes untreated, they are at risk of developing an infection in their bladder and lower urinary tract. 

Prostatitis is another condition that should be noted when looking at the prostate. This is an inflammation that affects the prostate. The inflammation causes the prostate to push against the urethra and the bladder neck. This is similar to what happens with benign prostatic hyperplasia. 

Sometimes prostatitis can be caused by a bacterium that entered the prostate gland. When this happens, the infection may develop in the area. 

This may lead to symptoms like:

  • Groin pain

  • Pain in the lower back area

  • A fever

There may be an increase in the frequency of urination. Men may also have a consistent urge to urinate throughout the day and when they try to sleep. 

Diagnosis Of Enlarged Prostate Gland And Urinary Problems

Many conditions that cause urinary symptoms in men can cause complications. The risk of developing these complications increase when the condition is not treated. Early treatment of prostate problems helps the condition improve. It also reduces the risk that the illness will progress. 

This is why an official diagnosis for a condition affecting the urinary tract and prostate is so essential. 

The diagnosis process will always start with a consultation at a doctor. The patient should ideally make a list of the symptoms they experience. This will help the doctor have a better idea of what may be the cause. 

The doctor will also ask the patient about their medical history. If the patient had surgery or chemotherapy in the groin region previously, they should ensure this is mentioned to the doctor too. 

A physical examination will be conducted during the initial consultation. The doctor will feel the groin and pelvis area. This will allow them to identify any abnormalities that may be present in the area. 

If a prostate problem is suspected, the doctor may also advise the patient to undergo a digital rectal exam3. 

There are a few reasons why a doctor may suspect problems with the patient’s prostate. The man may have urinary incontinence or voiding dysfunction. An overactive bladder, detrusor overactivity, and general bladder dysfunction may all be concerns. 

This is a relatively simple procedure, but maybe uncomfortable for men. It is a necessary process used to help a doctor determine if there may be a problem with the man’s prostate. During the procedure, a glove is placed on the doctor’s hand. They then insert one finger into the rectum of the patient. The doctor will press against the area where the prostate is located. 

The rectal exam findings allow the doctor to better understand why the patient may be experiencing the urinary symptoms. 

Additional tests may be ordered depending on the specific symptoms and the findings of the rectal exam. 

The doctor may require imaging tests if they suspect an enlarged prostate. The same tests may be used in cases where problems with the urinary sphincter or bladder outlet obstruction are suspected. 

Different types of imaging tests can be used. Some of these tests can even help a doctor identify bladder tumors. Issues with the pelvic floor muscle can also sometimes be identified with the use of these imaging tests. 

There are a few blood tests that a doctor may perform too. This is often the case when the man has a recurrent urinary tract infection. If there are problems with the prostate, certain tests may be performed to see if the PSA levels are raised. In such a case, prostate cancer may be a possible diagnosis the doctor may consider. 

Self-Help Strategies For Urinary Problems

Men with urinary urgency, frequent urination, and other issues with their bladder function can sometimes improve the symptoms with some self-help strategies.

It is important to note that these strategies do not always provide adequate help to the patient’s needs. Men should know when they need medical help – and when these self-help strategies may be appropriate. 

In some cases, pelvic floor therapy may be useful. There is a technique known as Kegel exercises that a lot of men have tried out. When the muscles in the pelvic floor are weak, then a man may experience some urinary symptoms. By performing Kegel exercises, it is sometimes possible to improve the strength of these muscles. This may restore adequate control over the bladder. 

Hydration is a critical part of keeping the urinary system functioning and cleansing the body. There is evidence that poor hydration may even increase a person’s risk of developing a urinary tract infection4. Urination helps to flush out the bacteria that are known to cause these infections. 

Men with an enlarged prostate should consider strategies that may help with the condition. Apart from medical interventions, there are a few natural ways to reduce the size of the prostate. 

Several natural herbs have been shown to provide effective results. In one study5, urinary retention symptoms in men with BPH were significantly reduced by Stinging Nettle. Dandelion is sometimes consumed as a tea to provide anti-inflammatory effects in the urinary tract and prostate. 

Treatment For Urinary Problems

Treatment for serious urinary problems should be administered early on. This helps the man experience a lower chance of complications. Sometimes, complications caused by the insufficient treatment provided for urinary problems can lead to serious health problems. 

The treatment used to treat urinary problems depend on a few factors. The cause behind these symptoms is the essential factor that will be considered. 

In many cases, men will be provided with certain medications to help treat their urinary symptoms. 

Some drugs may help to reduce constriction in the urethra. This is useful when there are problems with the flow of urine. Some drugs may help to reduce the prostate’s size. Men with BPH can benefit from these medicines. 

A few pharmaceutical drugs have been developed to help relax the muscles located at the bladder’s neck. These help to reduce unnecessary contractions. It may also help with symptoms like urinary urgency. 

Antibiotics may be used if the man has bacterial prostatitis. This is a strategy to help treat a urinary infection too. 

In rare cases, a doctor may advise a patient to undergo a surgical procedure. This is usually only the case when other treatments have failed to produce effective results. 

The surgery depends on the reason why the man experiences urinary symptoms. Some surgical options include:

Conclusion

Voiding dysfunction and other urinary problems are common among the male population. These symptoms can be a sign of several issues. Prostate problems, such as benign prostatic hyperplasia, are often the reason behind urinary symptoms in men.

Men need to understand what symptoms they should take note of. Knowing what treatment options are available can be helpful too. Several potential treatments can help to reduce these symptoms and address the underlying causes. 

Sources

  1. HHS Public Access. (2014) Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4156923/
  2. Reviews in Urology. (2009) Male Urinary Incontinence: Prevalence, Risk Factors, and Preventive Interventions. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2777062/
  3. StatPearls [Internet]. (2020) Rectal Exam. [online] Available at: https://www.ncbi.nlm.nih.gov/books/NBK537356/
  4. European Journal of Clinical Nutrition. (2003) Mild Dehydration: A Risk Factor of Urinary Tract Infection? [online] Available at: https://pubmed.ncbi.nlm.nih.gov/14681714/
  5. NCBI. (2015) The histological and historical effects of Urtica dioca extract on rat’s prostate hyperplasia. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4405682/

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