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As men age, the prostate tends to become enlarged and often cancerous. In fact, most older menshow signs of having microscopic cancers in their prostates. The enlargement, from both cancers and noncancerous causes (then called benign prostatic hypertrophy), can be highly uncomfortable. A swollen prostate cuts off urine flow, increases the need to urinate, and often makes urination painful. Sexual performance can become limited. And that ages us physiologically and psychologically.
Benign prostatic hyperplasia (BPH), also referred to as an enlarged prostate, constricts the urethra (the tube through which urine exits the bladder) and thickens the bladder wall. The bladder may begin to contract when it contains only small amounts of urine. One of the most common symptoms of BPH is more frequent urination; other signs include straining to urinate, a weak urine stream, and incomplete emptying of the bladder. However, only about half of men with BPH have symptoms that are noticeable or that cause them to seek medical treatment.
As a man ages, his prostate gland grows larger, which can cause urinary obstructive symptoms, such as difficulty with the flow of urine, dribbling and waking up at night. The enlargement of the prostate gland generally occurs in men from age 50 and older.
Symptoms of an enlarged prostate include: difficulty starting a urine stream, decreased strength of urine stream, dribbling after urination, feeling that the bladder is not completely empty, the urge to urinate soon after finished urinating and pain during urination.
The most common symptoms of benign prostatic hyperplasia (BPH), or enlarged prostate, involve changes or problems with urination, including:
- interrupted, weak urine stream
- urgency, leaking, or dribbling
- a sense of incomplete emptying
- more frequent urination, especially at night
- hesitancy in terms of taking a long time to initiate the urine stream
Because an enlarged prostate can pinch off the flow of urine, benign prostate enlargement (BPH) is characterized by symptoms of bladder obstruction, such as increased urinary frequency, nighttime awakening to empty the bladder, and reduced force and caliber (speed of flow) of urination.
The symptoms of prostate enlargement may include problems with urinating as the prostate tissue grows, squeezing and partially blocking the urethra, the drainage tube through which urine flows out of the body. Other symptoms may include:
- the need to urinate frequently
- difficulty in beginning to urinate and decreased strength and force of urinary stream
- dribbling after urination
- waking at night to urinate
- blood in the urine
The changes of prostate enlargement are very gradual over years. The symptoms can happen from either blockage of the flow of urine from the bladder or from irritation of the bladder. Symptoms of blockage happen when the enlarged prostate gland causes compression of the urethra, which carries the urine. This causes the force of the stream and the size of the stream to become smaller. Because more pressure must build up to cause the urine to pass, it takes longer to start the flow of urine. Since it may be harder to keep up the higher amount of pressure needed against the resistance, there may be an intermittent flow of urine -- waiting periods during urination -- until the bladder has completely emptied all of the urine. There may be some dribbling at the very end of urination.
The frequency of urination often increases when the prostate becomes enlarged. The bladder may not empty completely, as just discussed, so it must empty more often to eliminate the urine. Also, the prostate enlargement irritates the bladder and causes more frequent voiding and emptying. These feelings are more common at night when we do not consciously ignore the sensations. At night the tightness of the muscles that control the release of urine is usually less, which adds to the frequency.
This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.