Urge to urinate

[tommy58]

A year or so ago I was told I had an enlarged prostate but that it was nothing to worry about. However, over the last 3-4 months I’ve noticed that I need to urinate far more often than I used to, and I’m getting out of bed in the night at least once and sometimes twice to empty my bladder. Sometimes I do have slight leakage. Is there anything I can do about the leakage?

Are these two things connected and if so, should I be worried?
Thank you.

[Dr Jon Rees]

Hi,

no you shouldn't be worried, but it is defintely worth looking into this further as these symptoms must be causing you bother.

So, firstly, think about what you drink - do you drink a lot of tea / coffee / alcohol / fizzy drinks? If so, cut these right back andd try for a week or 2 on water - see what difference it makes to your symptoms. Also, if you drink much during the evening, try restricting fluids after 7 or 8pm and see if that helps the night times.

The leakage - is this a dribble after you walk away from the toilet, or a leakage at night when you are asleep, or something else? Dribbling after you finish is usually due to a slow flow, with urine pooling in the u-bend of your urethra, and escaping as you walk away - you can help this with a simple technique of pressing up with your fingers, behind the scrotum and squeezing forward - this can empty the last few mls of urine out and prevent that embarrassing leakage. Sometimes it takes a bit of practice!

If these simple things don't sort things out, then definitely worth going to discuss these symptoms with your GP.

Hope that helps....

[Mr Omer Karim]

As Dr Rees suggested, you should not be worried.
The "enlarged" prostate you have been diagnosed with could certainly be related to the urge to urinate you have been experiencing.
The prostate does not have to be particularly large to start to cause symptoms. Many men experience symptoms of an overactive bladder (detrusor overactivity) as a result of bladder outflow obstruction from an enlarged prostate. This is associated with a thickened bladder wall and a decrease in the elasticity (compliance) of the bladder. This will give symptoms of frequency of urination and urgency of urination. These symptoms will be aggravated by stimulants such as caffeine (in tea, coffee and fizzy drinks as Dr Rees intimated).

It might be worth seeing your GP sooner rather than later as detrusor overactivity secondary to bladder outflow obstruction does not usually resolve on it's own. Your GP might consider putting you on an alpha blocker +/- an anticholinergic.

Note: if you are a smoker the onset of these "irritable" urinary symptoms (frequency of urination, urgency of urination), without a slow flow of urine, are more ominous as could be a manifestaton of early bladder malignancy, hence the need to see a urologist at some stage.