Symptoms of BPH
Symptoms of BPH – It can through a number of mechanisms obstruct the urethra and cause urinary symptoms. There are two main ways in which it obstructs the urethra. Firstly, there is the static components of obstruction.
What this means is that as the prostate increases in size, it actually, the lobes grow to eclude the urethra and inhibit free urinary flow. There is a second component, the so-called dynamic components. The prostate is made up of both fibrous and muscular tissue.
This muscular tissue can contract and squeeze the urethra, again, inhibiting flow of urine. Invariably, in patients with benign prostatic hyperplasia, it’s a combination of both of these. What this means is that the inhibition of free flow of urine will result in a number of symptoms. Such as a poor flow with reduced flow rates, hesitancy with patients struggling to initiate voiding and intermittency where a patient will void in a stop-start manner.
On top of these obstructive symptoms, there are the so-called filling symptoms. As a prostate enlarges and obstructs the urethra, this has a secondary effect on the bladder. The bladder has to generate higher pressures in order to overcome the obstructing prostate.
What happens is the bladder becomes hyperactive and you develop a so-called unstable bladder. This will manifest itself in a number of symptoms such as urinary frequency; in other words, going to pass urine more often during the day than one would expect, urinary urgency where when you feel like you want to pass urine and you have to rush to the lavatory for fear of becoming incontinent, and nocturia where a patient would have to get up 2 to 3 times a night and sometimes more to pass urine.
Occasionally, the urinary symptoms can become very severe and a patient can find that they are unable to void. This is called acute urinary retention. In this situation a patient will need to have a urethral catheter inserted to drain the urine away.
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