Men with urinary problem - “Blame it on Prostate”

Jun 28, 2020
2 min read

Courtesy Wikimedia commons

Men -please be beware- not all urinary problems are due to Prostate.

When men come to my clinic with urinary problems, they always assume or someone might have told them that it is due to prostate. So, they quite often begin the conversation with a statement like this - “Doc, I have prostate problem”!. I will calm them down and ask them to tell the “full story”. Getting the full history is very important since patients give away their diagnosis with their story and what I need to do is to confirm or refute by getting some laboratory tests done.

By the way what and where is the prostate? It is a walnut- sized gland present only in men just at the junction between the bladder and the urinary tube. It encircles the urinary tube at the neck of the bladder like a doughnut and when it enlarges it strangles the passage.

As you grow older there will be certain changes in the bladder and the prostate. There may be overactivity or underactivity of the bladder. Prostate may enlarge and block the passage. So men beyond 50 or 55 may start noticing some changes in their urinary flow. They may have to get up at night many times to pass urine. There may be increased frequency during the daytime or they may not be able to control the the flow of urination. Previously this symptom complex was called as prostatism but later on the name was changed to lower urinary tract symptoms since women also suffer from these symptoms of frequency, urgency and slow flow.

There are many reasons for lower urinary tract symptoms but most often men may be told that they have prostate problem. It starts with “dysfunctional” water intake, heart problems, liver diseases, kidney related issues and medications.

I term this as dysfunctional, since people take gallons of water in the name of “hydrotherapy”. In modern medicine, this is questionable. We call them as habitual drinkers and not surprisingly they will be visiting the toilet quite often, especially during the night.

Heart conditions may cause water retention in the body especially in the legs and the feet and this will get expelled at night when they assume the lying posture. Both liver and kidney problems can also cause water retention in the body and may be responsible for urinary problems.

So, the first step to identify where the problem is, is to get something called “frequency volume chart”. Patients will be asked to fill out a chart for 3 days indicating their liquid intake and urinary output. This is also called bladder diary. I have attached a link showing the Bladder diary (© British Association of Urological Surgeons (BAUS) Limited)