Male Urinary Diseases
Many men have urinary symptoms such as frequent visits to pass urine, needing to pass urine again soon after visiting the toilet and occasionally, sudden urge to pass urine, which may result in urine leakage. In addition, some may experience poor urinary flow with dribbling, the need to strain to empty the bladder and sensation of incomplete bladder emptying.
These urinary problems can either be due to the bladder or bladder outlet (tube for urine to flow from the bladder and out of the body) or both. To distinguish between the two, urodynamic study – a specialised test to evaluate the functions of the bladder – is helpful. Research on urodyanmic studies in males has shown that for most men above 50 years old, the cause is usually due to the bladder outlet and specifically, the prostate.
The prostate is an organ found only in men and is located below the bladder, forming part of the bladder outlet. The prostate produces a liquid which mixes with sperms to form semen. For many men, with increasing age, the cells in the prostate increases in number and this may lead to a condition known as benign prostatic hyperplasia (BPH).
Benign prostatic hyperplasia is common and can result in poor urinary flow, dribbling of urine, the need to strain, sense of remnant urine in the bladder despite emptying the bladder, waking up in the middle of the night to void, needing to rush to the toilet, etc. A troublesome consequence is the inability to pass urine.
Treatment for benign prostate hyperplasia include medications and surgery. For surgery, it involves removing most part of the prostate and this can be accomplished via surgical instruments that are passed into the urine tube.
As for medications, there are many different types available. For example, one type causes the prostate to shrink and another relaxes the muscles around the neck of the bladder. The underlying treatment intent is to widen the urine tube, thereby facilitating urinary flow.
Younger men may experience similar symptoms but the cause may not be due to the benign prostatic hyperplasia. Other causes need to be considered and these include urethral strictures (narrowing of the urine tube) or primary bladder neck dysfunction. These require more specialised evaluation such as urethrogram and video urodynamic studies.
Whether young or old, many men are embarassed to talk about it, either with relatives or close friends or even with their spouses. Many incorrectly attribute their urinary symptoms to having a weak bladder or simply dismiss it as part of the ageing process. As a result, many suffer in silence for months or years. Medical therapy is available and it is beneficial for men with urinary problems to be properly evaluated and treated.