Almost all men over the age of 50 will have some degree of prostate enlargement, or benign prostatic hyperplasia (BPH). Possibly because of abnormal hormone metabolism that leads to an accumulation of dihydrotestosterone, approximately half of all men with BPH develop problems urinating, called clinical BPH. A hesitant, weak or interrupted stream, dribbling and getting up frequently at night are typical symptoms. A rectal examination and blood tests to rule out cancer can confirm the diagnosis. Few men develop complications.
Urinary Retention
The prostate gland surrounds the urethra, the pathway of urine leaving the bladder. In clinical BPH, enlargement of the prostate gland constricts the urethra, impeding urine flow. Urinary retention is the inability to completely empty the bladder, causing more frequent urination and a more urgent need to urinate. Sitting down on the toilet may empty the bladder better than standing up to urinate. A sudden and painful inability to urinate, called acute urinary retention, may require the insertion of a catheter to drain the bladder. Prolonged urinary retention causes the bladder to become distended, weak, tender and susceptible to infection. Overflow incontinence is the involuntary leakage of urine because of bladder weakness. Tiny blood vessels in the bladder and urethra may also be strained by retention or efforts to urinate; they may rupture, causing blood to appear in the urine.
Infection
Bladder stones may form from minerals that can't wash out of the bladder, causing irritation, infections, bloody urine and even blockage. Infection can be treated with antibiotics but may reoccur. Drinking pure cranberry juice may inhibit the growth of bacteria in the urine. Symptoms of an infection may include burning during urination, abdominal pain, cloudy urine and a constant urge to empty the bladder.
Kidney Disease
If the bladder does not empty, pressure on the kidneys can create swelling. In severe cases, kidney distention and toxins in the urine can impair the kidney's ability to filter wastes from the blood or cause permanent damage. Infection can also travel from the bladder to the kidneys, a more serious condition. Symptoms of a kidney infection, or pylonephritis, are fever, chills, pain in the testicles, lower back or flank. These symptoms should be evaluated by a health care professional immediately.
