The prostate is a male reproductive organ that surrounds the urethra just below the bladder. As men age, if the prostate tissue enlarges, it can press on the urethra or affect bladder function, leading to various urinary symptoms. This is called benign prostatic hyperplasia and is a condition different from cancer.
However, not all urinary discomfort is due to benign prostatic hyperplasia. Changes in bladder function, urinary tract infections, prostatitis, diabetes, and medications can also cause similar symptoms. Office workers who sit all day near Samseong Station may easily miss early changes because they endure going to the bathroom due to busy schedules or cope with caffeine drinks.
Divide into storage symptoms and discharge symptoms
Urination symptoms can largely be thought of as discomfort during the storage of urine and discomfort during actual urination.
Storage Symptoms
- Urinate frequently
- If you suddenly need to go, it’s hard to hold it in
- Wake up at night to urinate
Discharge Symptoms
- You have to wait because urination does not start immediately.
- The stem is weak or breaks in the middle
- You have to tighten your stomach to urinate.
- Even after watching it all, I feel like something remains
- Drops fall after urination
These symptoms commonly appear in benign prostatic hyperplasia, but they could also be due to prostatitis or other causes. If the symptoms recur, it is safer to confirm the cause through a urology consultation rather than self-diagnosis.
What should be checked during a medical examination?
In the clinic, they first check when the symptoms started, how many times you urinate during the day and night, and how much it affects your quality of life. Medications such as cold medicine, allergy medicine, diuretics, as well as caffeine and alcohol habits, are also important clues.
You can choose the following tests as needed.
- A urine test is used to check for hematuria or the possibility of infection.
- Flow rate test is used to examine the speed and pattern of urine flow.
- Post-void residual measurement checks the amount of urine remaining in the bladder after urination.
- Prostate examination and ultrasound are used to assess size and the possibility of other abnormalities.
- PSA blood test is determined by considering age, symptoms, family history, and examination results.
The size of the prostate does not necessarily correspond to the severity of symptoms. Even if the prostate appears large, discomfort may be minimal, and even if it is not large, symptoms can be severe due to bladder function or urethral resistance. Therefore, we interpret symptoms, physical examination, and test results together rather than relying on a single test value.
A 3-day urinary diary is helpful
For about three days before the consultation, try recording the time and amount of urination, the time and amount of water, coffee, and alcohol consumed, and whether there are sudden urges to urinate or incontinence. This helps determine whether nocturia is related to evening fluid intake and whether the total daily urine volume is high.
Criteria for Not Delaying Medical Treatment
Acute urinary retention, where difficulty urinating suddenly worsens or urine does not come out at all, requires prompt treatment. Seek medical attention without delay in the following situations as well.
- The lower abdomen feels tight and painful while no urine comes out at all
- Visible hematuria or clots appear
- There is painful urination or flank pain along with fever and chills
- There are recurring urinary tract infections
- There is unexplained weight loss or bone pain along with urinary symptoms
These symptoms cannot be seen as mere aging changes and other causes such as infection, stones, or bladder disease must be differentiated.
Treatment is tailored to symptoms and quality of life
If the symptoms are mild, do not greatly affect daily life, and the risk of complications is low, you can monitor the condition regularly while adjusting your lifestyle. If discomfort persists, medications that act on the prostate and bladder may be used, and depending on the type of medication, there may be side effects such as dizziness or changes in sexual function, so other medications and health conditions are considered together.
If problems such as insufficient control with medication, recurrent urinary retention, bladder stones, or impact on kidney function occur, procedures or surgery are considered. The treatment method depends on the size and shape of the prostate, whether you are taking anticoagulants, and the desired effects and concerns about side effects. Being diagnosed with benign prostatic hyperplasia does not mean immediate surgery.
Daily Life Management
- Reduce evening caffeine and alcohol — Coffee and alcohol can worsen urinary frequency, urgency, or nocturia. Check your personal response using a urination diary.
- Control your fluid intake timing — Consume the fluids you need during the day, but avoid drinking a lot right before bedtime. If you have heart or kidney disease, do not restrict fluids on your own and consult your healthcare provider.
- Do not hold urine for too long — Going to the bathroom before a meeting and, after urination, waiting a moment instead of getting up immediately and trying again can help relieve the feeling of incomplete emptying.
- Check the ingredients of cold medicine — Some decongestants or antihistamines can make urination difficult. If you have an enlarged prostate, inform your pharmacist or healthcare provider.
- Move regularly — Break up long periods of sitting and maintain consistent activities such as walking.
Nocturia may not be a problem solely related to the prostate. Since there are various causes such as sleep apnea, leg edema, diabetes, and excessive fluid intake in the evening, it is not appropriate to start taking prostate medication just because you wake up frequently at night.
Urination symptoms progress gradually, making it easy to become accustomed to the discomfort. If you find yourself first looking for the restroom, or if meetings, driving, or sleep have started to be disrupted, rather than waiting for the symptoms to worsen, objectively check your current condition.
This article is intended to provide general health information and does not replace diagnosis or treatment. If you have symptoms, consult a specialist.
