The prostate gland is part of the male reproductive system. It sits just below the bladder and encircles the urethra, the tube through which urine and semen pass out of the body. The prostate is normally about the size of a chestnut. However, as men age, the prostate commonly gets larger--a condition known as benign prostatic hyperplasia (BPH). According to the American Urological Association, BPH affects 50 percent of men between the ages of 51 and 60 and up to 90 percent of men over age 80. Prostate enlargement also occurs with prostate cancer. Urinary symptoms often occur with prostate enlargement as the gland encroaches on the neck of the urinary bladder and urethra and impedes normal urine flow.
Urinary Hesitancy
Men with prostate enlargement often experience a delay in the start of their urine stream when attempting to urinate.
Decreased Urinary Stream
Prostate enlargement may cause a weak urine stream, which seems slower than usual and results in a lower volume of urine than expected. There may be stopping and starting of the urine stream once urination has begun. Decreased urinary flow may also cause dribbling of urine at the end of urination.
Straining to Urinate
Prostate enlargement can cause a sense of needing to bear down or strain to force urine out of the bladder.
Urinary Urgency
In men with prostate enlargement, the urge to urinate may be sudden and nearly overwhelming; the need to find a bathroom is pressing and immediate.
Urinary Frequency
Many men with prostate enlargement have to urinate frequently. The need to urinate more often than every two hours is usually considered the threshold for increased urinary frequency.
Nocturia
Nocturia is the need to get up at night to urinate. Men with an enlarged prostate often need to get up one or more times during the night to urinate.
Incomplete Emptying of the Bladder
Incomplete emptying of the bladder is a common symptom in men with an enlarged prostate. The bladder may still feel full, but no more urine will come out. This typically causes urinary frequency since only a portion of the urine in the bladder is released with each urination attempt.
Urinary Incontinence
Prostate enlargement may cause urinary incontinence--the involuntary or accidental release of urine. Urge incontinence occurs when the compelling need to urinate cannot be stopped voluntarily. Overflow incontinence is the involuntary leakage of urine that occurs because the bladder is full, but is not being completely emptied at the time of urination.
References
- "Robbins Pathologic Basis of Disease, 5th Edition"; Ramzi S. Cotran, M.D., Vinay Kumar, M.D., Stanley L. Robbins, M.D., Frederick J. Schoen, M.D., Ph.D., Editors; 1994
- American Urological Association: Diagnosis of BPH
- American Urological Association: Natural history and diagnosis of prostate cancer
- "Harrison's Principles of Internal Medicine, 16th Edition"; Anthony S. Fauci, M.D., Eugene Braunwald, M.D., J. Larry Jameson, M.D., Ph.D., Dennis L. Kasper, M.D., Stephen L. Hauser, M.D., Dan L. Longo, M.D., Editors; 2004
- Merck Manual: Benign prostatic hyperplasia
