What can cause urinary problems in men besides an enlarged prostate?

It was once thought that the urinary difficulties that men experience as they age were the result of an enlarging prostate constricting the urethra. If this were the case, symptoms would tend to get worse as the prostate got larger. But this is not the case. Rather, the smooth muscle in the prostate and the bladder also play key roles in causing urinary symptoms. When the smooth muscle gets chronically tense, it puts pressure on the urethra and bladder neck, increasing the resistance to urine flow. And, as resistance to urine flow increases, the bladder has to work harder to empty itself. To do this, the bladder contracts its muscular wall, called the detrusor muscle. This action causes the muscle to thicken and get stronger, further reducing the capacity of the bladder.

Sometimes the muscle contracts when the bladder is not full, giving the sensation of needing to urinate. Over time, as the bladder tries harder to empty itself, it becomes less efficient. The result: The need to urinate more frequently and the sensation of not having emptied the bladder of urine.

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