If you are a man over 50 and are having difficulty urinating, have the sudden urge to “go”, or wake up often at night to urinate, you may have bladder issue; but it could also be a sign of a problem with your prostate.
The prostate is a walnut-shaped gland that sits below the bladder and surrounds the urethra, which is the tube that carries urine out of the bladder. As men get older then the prostate gland tends to get larger. If the prostate gets too large, it can cause blockage of the urethra and this can cause problems with urinating.
How do you know what’s causing the enlarged prostate?
The most common prostate problem in men under 50 is prostatitis. This is sometimes caused by bacterial infections and can be treated with antibiotics. Symptoms include fever, chills, and aches, along with pain while urinating, or the inability to urinate, going frequently, or leaking urine. If you have sudden onset of any of these symptoms or cannot urinate at all, seek immediate medical treatment.
Unfortunately, the cause of prostatitis isn’t known. This is known as Chronic prostatitis, or chronic pelvic pain syndrome. About 10–15% of the U.S. population has this condition that comes and goes. Chronic prostatitis can cause pain or discomfort in the groin or lower back. Treatment may require a combination of medicine, surgery, and lifestyle changes.
The most common prostate issue for men older than 50 is benign prostatic hyperplasia (BPH). This is shown in nearly half of men over 50 and about 90% of men over 80 years old. In more extreme cases, BPH can lead to urinary tract infections, bladder stones, or kidney failure if left untreated. In most cases, prescription medication or surgery can relieve symptoms.
A third cause of an enlarged prostate is cancer. Prostate cancer is the second most common cause of cancer in men in the United States. It is the second leading cause of death from cancer in men (second to lung cancer) and is more common in African-American men than in white men. About 1 in 7 men will be diagnosed with prostate cancer. Most men with prostate cancer are older than 65 years and do not die from the disease.
Prostate cancer grows very slowly. In fact, it may take 10 or more years before a tumor gets big enough to cause symptoms. Advanced prostate cancer can cause men to urinate more often or have weaker urine flow. But, like you’ve read above, these are the same symptoms as benign prostate conditions.
Once a tumor becomes large enough to cause symptoms, they may includes:
- A frequent need to urinate, especially at night
- Difficulty starting or stopping a stream of urine
- A weak or interrupted urine stream
- Leaking or urine when laughing or coughing
- Inability to urinate standing up
- A painful or burning sensation during urination or ejaculation
- Blood in the urine or semen
Symptoms of advanced prostate cancer include:
- Dull, deep pain or stiffness in the pelvis, lower back, ribs, or upper thighs; pain in the bones of those areas
- Weight loss
- Loss of appetite
- Fatigue, nausea, or vomiting
- Swelling of lower extremities
- Difficulty walking
- Weakness or paralysis in the lower limbs, often with constipation
There are a few studies of thought in terms of testing for prostate cancer. Some doctors may recommend an active surveillance approach. This approach usually includes a visit to the doctor and regular prostate-specific antigen (PSA) blood test and a digital rectal exam (DRE) every six months. The doctor will monitor the results and if they change, the doctor would discuss treatment options.
Some doctors prefer observation of symptoms rather than performing tests. If symptoms change, then treatments can be determined.
The good news is that the drugs to shrink the gland are inexpensive. So, it’s important to have your yearly physical, and talk with your doctor if you have problems urinating or feel discomfort. Letting him know of any changes in your body or symptoms you may be experiencing, will help determine if you will need surgery, or if treating with medications will be your best option.
Sources: National Institute of Health, WebMD, and Cancer.org.