Symptoms
The symptoms commonly associated with BPH are collectively called lower urinary tract symptoms (LUTS). BPH is not always the cause of these symptoms. An enlarged prostate may be accompanied by few symptoms, while severe LUTS may be present with normal or even small prostates and are most likely due to other conditions. Many experts are now categorizing LUTS are as either voiding or storage symptoms to help define the source of the problem.
Voiding (Obstructive) Symptoms
Voiding symptoms, also referred to as obstructive symptoms, can be caused by an obstruction in the urinary tract. They are often due to BPH. Obstruction is the most serious complication of BPH and requires medical attention. Voiding symptoms include:
- Weak or intermittent urinary stream
- Straining when urinating
- A hesitation before urine flow starts
- A sense that the bladder has not emptied completely
- Dribbling at the end of urination or leakage afterward
- Painful urination
- Hematuria (blood in the urine)
Storage (Irritative) Symptoms
Storage symptoms, also referred to as irritative symptoms, include:
- An increased frequency of urination, particularly at night
- An urgent need to urinate
- Bladder pain or irritation when urinating
The Process of Urination
The process of urination is more complicated than it appears:
- It begins when waste fluids flow out of the kidneys into two long tubes called ureters.
- The ureters empty into the bladder, which rests on top of the pelvic floor, a muscular structure similar to a sling running between the pubic bone and the base of the spine.
- The brain regulates muscles in the urinary tract through a pathway of nerves. As the bladder fills to its capacity of 8 - 16 oz of fluid, the nerves send signals from the bladder to the brain that indicate how full the bladder is.
- As the bladder swells, the muscles contract to prevent urination.
- At the time of urination, the spinal cord initiates the voiding reflex. The detrusor muscles (which surround the bladder) contract, while the internal sphincter (a strong muscle encircling the neck of the bladder) relaxes.
- When the internal sphincter is open, urine flows out of the bladder into the urethra (the tube that carries urine from the bladder out through the penis).
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