Enlarged Prostate

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Symptoms

Symptoms can be divided into obstructive symptoms and irritative symptoms.

Obstructive voiding (urinating) symptoms:

These symptoms are caused by the pressure upon the urethra by the prostate:

  • Hesitancy (delay in beginning urination)
  • Decreased force or caliber of stream
  • Incomplete emptying of bladder (perceived or real)
  • Double voiding (the need to urinate soon after one has already urinated)
  • Straining to urinate
  • Post-void dribbling (dripping urine right after urination)

Occasionally, obstructive symptoms may be so severe as to altogether prevent urination, due to complete blockage of the urethra. This entity is called acute urinary retention, and is a medical emergency that requires immediate catheterization to drain the bladder.

Irritative voiding symptoms:

These are caused by the upward pressure upon the bladder by the prostate or thickening of the bladder muscle as it works harder to squeeze urine out against the resistance of the prostate. The bladder's response to BPH can result in:

  • Urgency (the sudden and immediate need to urinate)
  • Frequency (the recurrent sensation to urinate with little time between urinations)
  • Nocturia (numerous and frequent night-time awakenings due to the need to urinate)

Untreated and prolonged BPH can result in damage to the bladder, ureters and kidneys. This may manifest as the inability to sense bladder fullness, inability of the bladder to contract in order to empty itself of urine, bladder diverticula (herniation of bladder lining through the bladder muscle), bladder stones, recurrent or severe infection, or renal failure.

BPH can also cause hematuria (bloody urine). This is due to tearing of enlarged blood vessels on the prostate.