How does prostate enlargement cause pain or discomfort during urination?
Prostate enlargement or benign prostatic hyperplasia (BPH) can lead to pain or discomfort during urination due to the way the enlarged prostate gland interacts with the urinary system. Here is how:
Pressure on the Urethra: The prostate gland surrounds the urethra, the tube that carries urine from the bladder out of the body. As the prostate gland grows larger, it pinches the urethra, making it smaller and making it harder for urine to flow easily. The blockage can cause a feeling of discomfort or pain when urinating.
Bladder Irritation: As the prostate enlarges and blocks the flow of urine, the bladder may become overactive, causing symptoms like frequent urination, urgency, and not being able to fully empty the bladder. This can cause pain or burning during urination.
Incomplete Emptying of the Bladder: When the enlarged prostate interferes with urine flow, the bladder might not be completely emptied. This will result in a sensation of fullness or discomfort in the bladder and can also lead to urinary tract infections that can result in further pain.
More Straining: Some men with BPH must strain to urinate because the enlarged prostate is blocking the flow. The additional pressure can be uncomfortable or painful.
If an enlarged prostate’s symptoms are causing significant discomfort or pain, one should consult a health provider. They can offer medications or other options to manage the symptoms and reduce the discomfort.
Chronic urinary retention due to prostate enlargement, typically caused by benign prostatic hyperplasia or BPH, occurs when an enlarged prostate obstructs the flow of urine from the bladder, causing difficulty in urinating, along with other associated symptoms. Chronic urinary retention symptoms can be mild in character, but they typically manifest both storage and voiding symptoms.
Symptoms of Chronic Urinary Retention Due to Prostate Enlargement:
Difficulty Starting Urination (Hesitancy):
The enlargement of the prostate can block the urethra, and it becomes harder to initiate urination. Individuals may have the urge to urinate but be unable to initiate the flow.
Weak Urine Stream:
The urine flow may be weak or interrupted, even when trying to urinate for a long time. It is due to the narrowing of the urethra from the enlarged prostate.
Frequent Urination (Especially at Night – Nocturia):
Frequency of micturition, particularly at night (nocturia), is common. This can lead to disturbance of sleep, as the individual must wake up several times at night to void urine.
Urgency:
A strong, often sudden, desire to urinate that is difficult to defer even when the bladder is not full. This can lead to accidents or incomplete emptying of the bladder.
Incomplete Emptying of the Bladder:
Even after urinating, there may be a sensation of the bladder not being empty. This is due to the fact that the urethra is blocked and does not permit full emptying.
Dribbling After Urination:
In some individuals, there may be post-urination dribbling with tiny amounts of urine still flowing out even after urination has finished.
Pain or Discomfort:
Some people with chronic urinary retention may experience a feeling of pain or pressure in the lower abdomen or pelvic area, as the bladder becomes overdistended.
Urinary Retention and Inability to Void (Acute Retention):
In extreme cases, there may be a total inability to urinate, leading to acute urinary retention. This is an emergency situation that requires immediate action, often in the form of catheterization to relieve the pressure and prevent damage to the bladder or kidneys.
Urinary Tract Infections (UTIs):
Chronic retention of urine can also enhance the risk of acquiring urinary tract infections. Burning or pain during urination, cloudy or offensive-smelling urine, and fever can be signs of a UTI.
Kidney Damage:
Eventually, if left untreated, chronic urinary retention may result in kidney damage due to the backward flow of urine (hydronephrosis) and may create symptoms such as pain in the flank region or leg swelling.
Other Considerations:
Gradual Onset: Symptoms of chronic urinary retention due to benign prostatic enlargement set in gradually, and the individual may get used to the urinary changes over a period of time, even delaying a visit to the physician.
Effect on Quality of Life: Symptoms, especially nocturia, frequency of urination urges, and the sensation of incomplete bladder emptying, can significantly affect the quality of life, resulting in sleep loss, anxiety, and frustration.
When to Seek Medical Help:
If any of the above symptoms are severe or if there is an acute urinary retention (unable to urinate), it’s necessary to get immediate medical attention. If chronic urinary retention is not treated, it can lead to complications such as urinary tract infections, bladder stones, or kidney damage. Some of the treatment options for urinary retention caused by BPH include medications (e.g., alpha-blockers or 5-alpha-reductase inhibitors), lifestyle changes, and surgery such as a transurethral resection of the prostate (TURP) or laser surgery.