Prostate Symptoms (or LUTS)
Men often develop urinary symptoms as they get older, and they may bother them. Lower urinary tract symptoms (or LUTS) are often due to benign prostate enlargement (or BPH).
Lower urinary tract symptoms (or LUTS) may include
- difficulty starting a urinary flow
- slow urinary stream with interrupted flow
- incomplete bladder emptying, or
- the bladder may become overactive (OAB) with frequent urination, a sensation of urgency to pass urine and nocturia (needing to wake to pass urine during the night)
- Urinary incontinence may occur
What is the Prostate?
The prostate is a gland the size of a small fig, just below the urinary bladder. As men get older, their prostates get bigger and can squeeze the urethra (the tube that passes down through the centre of the prostate). This enlargement can block the flow of urine and cause urinary obstruction.
Prostate enlargement (or BPH) may cause symptoms in the 50's, 60's, 70's or later! Prostate cancer can also cause symptoms of obstruction, but this is not usually a symptom of early prostate cancer.
Your prostate assessment will include:
- a Prostate Cancer risk assessment with PSA, internal digital rectal examination (or DRE), and possibly MRI Prostate
- a symptom score (IPSS) to assess severity of symptoms, and
- urinary tract ultrasound - to ensure you are emptying your bladder and that there are no complications of obstruction (chronic urinary retention, bladder stones or kidney problems)
Nothing - if your symptoms are mild or moderate and do not bother you, and your Prostate cancer risk is low, you probably don't need treatment! You may need follow-up with your GP or Mr Stephen Lindsay.
Bladder retraining - if your bladder is overactive, bladder retraining and/or medication may help. This can reduce your urinary frequency, sensation of urgency and urinary incontinence and can increase your functional bladder capacity.
Medication - can improve your urinary flow by relaxing the muscles in the bladder neck and prostate. Some medication can shrink the prostate. Medication is usually the first line treatment for men with mild to moderate symptoms - but you will need to keep taking the medication to get the benefit.
Prostate surgery - a TURP or "rebore" is the gold standard for treatment for men with severe, bothersome symptoms or when medical treatment has not worked. Surgery is also needed for men with complications of obstruction, such as infection, bladder stones or kidney problems due to back-pressure from the prostate. Some men will need urgent surgery if they develop a complete blockage (acute retention).