What are the symptoms of benign prostatic hyperplasia?
Obstructive symptoms:
- Difficulty and delay – hesitancy – in initiating urination.
- Decrease in the force of the stream.
- Choppy and dispersed stream -in sprinkler-.
- Dribbling after finishing urination -postmicturition-.
- Sensation of not having finished urinating, having to urinate again a little later.
- Exertion of force with the abdominal musculature in order to urinate.
Irritative symptoms:
- Increased frequency of urination, both during the day -polaquiuria- and at night -nocturia-.
- Urgency and urgency to urinate.
- Itching and burning during urination.
- Pain in the lower abdomen -hypogastrium-, which may radiate towards the testicles.
Can BPH affect the bladder?
Since the prostatic adenoma represents an obstruction to the outflow of urine, the bladder produces a thickening of its musculature with the intention of having more power of contraction, and thus overcome the obstacle.
This change in bladder muscle tissues can cause spasm and involuntary contractions of the bladder, with the consequent pain and urgency of urination.
Is nocturia -increased frequency of nocturnal micturition- an exclusive symptom of BPH?
No, not at all. Congestive heart failure -difficulty for the heart to pump blood- causes that, at night, when lying in bed, the edemas of the legs are mobilized and filtered by the kidneys, thus eliminating the liquid retained throughout the day. This increases the amount of urine and, therefore, the frequency of urination. It can also occur nocturnally in those who have a large fluid intake before bedtime.
Why can BPH cause pain in the testicles?
Due to the difficulty in urine outflow, it refluxes towards the prostatic ejaculatory ducts -which is where the semen comes out at the moment of orgasm-, irritating the seminal duct and causing discomfort at testicular level. It can even cause infection -orchitis and orchiepididymitis-.
Are there drugs that worsen prostate symptoms?
Yes, they do. They can be facilitated by antidepressants, diuretics and relaxants of the bladder muscles. All of them can make it difficult for urine to flow out of the bladder, sometimes requiring the placement of a catheter for drainage.
What do we understand by “acute urinary retention”?
It consists in the fact that, at a given moment, the person is unable to urinate on his or her own, in spite of having a strong desire to do so. It is usually accompanied by intense pain in the lower abdomen, since the bladder is under tension, full of urine. When this occurs, it is necessary to place a bladder catheter for emptying.
What can happen if BPH is not treated?
We can face the following situations:
- Urine infection, since when urine is retained in the bladder, it is a good breeding ground for germs to grow.
- Stones in the bladder, because the sediment or sediment of the urine causes them to join, and progressively generate the matrix of a stone or bladder lithiasis.
- Ureterohydronephrosis, or dilatation of the urinary tract of the kidneys and ureters, causing the urine to stagnate at the level of the kidneys and ureters. This can lead to a decrease in renal function – renal insufficiency – which can be seen in blood tests by elevated urea and creatinine levels, and a decrease in glomerular filtration rate.
- Acute retention of urine, due to the impossibility for the bladder to overcome the prostatic obstruction, which causes a painful repletion of the bladder that urgently requires the placement of a bladder catheter.